The Nursing Diary
Entering the world of professionalism, in the healthcare industry for the first time!!
Follow this space for the ups and downs of a functional yet dysfunctional nursing graduate!
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Rotation One:
Rotation Two:
1. Flying Solo
22nd Feburary
Despite the years of study and mindless hours of placement nothing quite prepares you for the feeling of riding solo. Every time I document or give a medication I still feel like I should be waiting for my buddy nurses look of approval. But that’s all YOU now!!
Don’t get me wrong that’s also one of the best feelings…. having the satisfaction of knowing there is no one looking over your shoulder. Your clinical judgment is now your own and senior nurses are generally always there to help you! I’m very lucky to be at a hospital ward where everyone is extremely supportive and they know that there is a lot your unsure of as a novice nurse and always happy to help!
However I write this having just finished my first solo shift…I started the day slightly nervous and that was alleviated relatively quickly being placed with patients I already knew, removing an element of uncertainty.
However I cant help but feel like nothing went right….I may be being a little hard on myself. I delivered all patient care, completed all the tasks required of me with no mishaps however with a full patient load comes the constant uncertainty and always having something to do or a task that needs completing, I felt slightly out of my depth.
Rushing to finish my notes towards the end was a triumph, while finding the time to handover to oncoming staff and get out at a reasonable time. Finally I walked out of those hospital doors, breathing a massive sigh of relief! But that anxiety and angst still hangs with me, the feeling that what I completed wasn’t good enough or inadequate. Coming from a senior role at a part time job to junior staff of course has its differences and the unknown will become less encompassing. However that looming feeling hanging over me right now is horrible.
Your told as a novice nurse you’ll have shifts that are great and ones you walk away from crying. I can’t say I fit into either of those categories right now, it certainly wasn’t terrible, but I just feel helpless…. First shift as a graduate nurse TICK. What comes next, I’m not sure, read on to find out….
2. Two weeks and counting...
2nd March
Every single shift I go to work I just pray that everything is going to be all right. I’ve been in a constant state of anxiety for the passed two weeks, the feeling in the pit of my stomach butterflies mixed with blades every time before a shift.
I was talking to one of my fellow grads and this is what she said to me ‘I thought I would love my job but I don’t’ hearing someone else voice how I had been feeling, was a huge relief. My response to her was we are still new, we're basically like a shiny pair of leather boots, your going to bleed the first few times you were them but they will eventually turn into the most comfortable pair of shoes you own. We still have a lot to learn and with time the uncertain wont be so scary. I’m aware of this and believe it’s very true.
But here is the truth about my grad experience soo far, there are the nurses that will help you and the ones that will not. There are the condescending doctors and the ones like saints. Your watched like a hawk and told to fly like an eagle.
Your patients are your own and all the responsibility falls to you, they know you’re a novice so the senior staff are there for you, but they also have their own patients. When it comes to medication or fluid checks finding someone can be near impossible and just wait for a task your unsure of, finding a helper can sometimes be like looking for a diamond in sand. Especially if all the nurses on that shift aren’t a fan of grads, because trust me they exist, in such a team orientated environment you would be surprised the number of nurses unwilling to give a hand. However the idea of having to show someone something or taking that moment out of your day can often be something your coworkers are unwilling to share.
Don’t get me wrong there are clinical nurses and they come around and are there for you, however there is that time where you kinda can't learn, you just have to do. Especially when it comes to things that you are expected to know, so start practicing because - its all on you now! One of the most challenging things I have found so far is dealing with confused and disorientated patients, leaving them is really not easy; they’re incredibly hard to reason with. And when multiple of your patients are disorientated your playing duck duck goose around the room just trying to keep your patients seated meanwhile trying to keep up with your daily workload.
My tactic so far with nursing has been to learn as I go. I do most of my work without the help of other nurses (it becomes habitual as support can often be lacking) and thus you pick it up along the way. When it comes to procedures I’ve never done before, you ask for help (yes sometimes with an unwilling participant) but I’d rather piss a coworker off than loose a patient.
The level of responsibility on you is incredible and it’s your registration on the line now, so vigilance is vital. Now I was lucky enough to get my Grad position in a major Public Hospital and Yes, their program has a very prestigious reputation so No, this experience isn’t from a small hospital or private whom can (definitely not all) have very unsupported programs. Don’t get me wrong my program has a lot of clinical support in place and supernumerary study. But as a fish out of water soo far this has been my experience, we shall see what the next few weeks have in store. To the great unknown and hope of suretyy.
3. It gets better....I promise
16th March
All right ill be honest here, for the passed two weeks I’ve hated my job!! I don’t like to use the word hate but in this sense, it was completely and utterly true!
Although its safe to say I’ve reached a plateau in the theatrical sense….the storm to my calm has finally past, well at least for the time being.
The complete and utter helplessness is no longer so unknown. I feel like that baby bird that left the nest and landed on the neighbouring branch instead of falling to my inevitable demise.
Work is good!! The hospital is no longer a mind field….I have a better understanding of where I fit into the healthcare hierarchy! Who to ask for help…which nurses are going to be there for you and those that are ready to watch you burn!
A large part of my sudden found satiety has to do with the people. My previous jobs in hospitality had been good but the reason I loved my work was because of the friends and people I worked with, it wasn’t work because it meant I got to see them. That sense of family….I’m finally starting to feel it at the hospital.
The other grads will be your bread and butter! Not only are they going through the same experiences as you, nurses are nearly always great people! (aside from those few older nurses who will never change). I finally found my place and a great group of friends with it.
I attended my first MET call today….when the sound of the PA comes and you hear MET call to floor….you dread that it's your floor (let alone your patient…that I am yet to experience). Especially as a grad the idea of a MET call or Code means a room full of superior nurses and doctors with high expectations.
Don’t get me wrong you can get a great team from time to time but that one MET team full of arrogant doctors is horrible. My first MET call experience however wasn’t horrible…I scribed (which for anyone new to it like me…take the point of scribing) as the scribe you don’t participate directly you’re the observer writing down vitals and listening to the doctors for the next thing to write. The MET call ill say wasn’t life threatening and luckily there was a educator there soo she basically talked me through the whole thing, but next time I’d feel more than happy to take it upon myself!
I now walk onto a shift yes expecting the unknown but also knowing that it's going to be ok. The procedures are there, the unknown isn’t that bad and when it is…you wont be alone!
4. The Ebs and Flows
22nd March
Its 2AM and my shift finished over 5 hours ago, however it’s been on my mind since I left. The anxiety and palpitations have been coursing through my body ever since.
One thing, literally one thing that wasn’t even my fault, yet I feel like it is! I did nothing wrong. Your always-told nursing is a 24hr job, so things are handed over to you, and as a novice your clinical judgment is still being shaped. So when someone hands something over, you just take it for what it is, expecting it to be correct. Yet that’s not always the case.
And despite the fact I was not in the wrong, I literally haven’t thought about anything else. I am going to be back there in less than 6 hours and I am literally dreading it!
I feel soo helpless, I feel like I never do anything right and with a job where peoples lives are literally in your hands there is no room for error.
I can guarantee 99% of the other nurses think I’m clueless. Wanting to be good at something and trying yet always coming up short!! When will that end.
Plus as the shiny new toy, coming into a play ground where everyone has there own clique and groups is hard. I feel like buzz light year at the beginning!! Nursing is a minefield……yet I might just have to embrace it.
5. Highschool 2.0
5th June
Friends....work is the predominant place that you make them right (setting aside school/uni). You see the close friendships between your coworkers and their inside jokes, which comes with time yeas, feeling like an outsider wont last forever.
In the last three months I can honestly say I've met some great people...despite of course the odd discouraging and bewildering senior nurse.
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But you didn't think that other Grads would be a course for conflict....don't get me wrong all the other girls are really great and their fun, they are definitely a small part of what makes working there better.
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But there is always that one person, that one individual who seems to put themselves a little bit higher than everyone else. At the beginning I use to notice she would be quick to judge our fellow peers, yet we are all new, soo I always tried to put their misfailings in a positive light because at the end of the day mistakes happen! and who are we as junior nurses to judge someone for not knowing when we are just as outranked in superiority as them.
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Despite being a lovely person, this girl lets call her Jill, she creates somewhat of a bidding war in her mind, some kind of mentality where she put others down for their misfailings. When in all honestly she is not doing anything different to all of us....I remember the first time she asked me "what do you think of.....?." and if I am being honest yes I had noticed that one of our fellow Grads was a little more inexperienced but who are we to judge, we all go through stages of not knowing, so I felt passing judgement so quickly was relatively unfair.
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So I answered the question and let that one slide thinking that she was being a little harsh but I'd be lying if i said i did not see what she sees, despite the fact I just would not have voiced my opinion soo avidly. Now a month or so later, I see the way she acts around me and a few of the other Grad's there is this sense that we do not know as much as her and how low of us to ask that question or why do that..as if our clinical judgement is insignificant in comparison to hers.
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Human beings I guess its the age hold Regina George scenario (funnily enough she seems to spend a lot of time talking to the other people on the ward and I feel like being apart of their friendship dynamic has given her a sense of ownership and superiority).
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I just kind of thought the bitchiness of high school would pass with maturity, however that thinking was a little too premature I'm afraid! I know that people are callas and quite often cruel but, I think what shocked me was I just didn't expect it from a fellow Grad. Someone whom I thought I could trust is actually the person I feel that if i ever did confine in would probably be the first to dob me in.
6. Solis In Numbers
18th June
I would be lying if I said I had not been feeling a little bit down about work at the moment. Its not the work, labour or patients as such its more the environment, this is a bit of a follow on from my previous post. I was talking to one of my fellow grads, Emma. Love her she's an absolute gem, literally she has me in tears of laughter day in day out. She was actually an Enrolled Nurse for years only just picking up the RN later in life.
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I remember in the very first week talking to her about how much she was struggling to keep up with our new work load, the responsibility and the great unknown that was now our job and she was lost! Hearing someone who had been in the healthcare industry before yet still feeling like she was flailing at the seams made my insecurity sooo much less.]!
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We were having one of our usual DnM's, it was a bit of a bitch sess about our fellow co-workers (a much needed vent sess, if you ask me). She was saying how she still felt like she was on the outskirts, a bystander to the society - that is the work place. The main difference now being, we are self-sufficient enough in our work we do not constantly need that guiding hand however as a nurse 80% of your job requires 2*assistance. Your like that kid in sports class who gets picked last for the team, basically trying to hail a cab without any cars driving by!
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But I honestly think the worst part is when you have done your notes and all the tasks you need to complete, so your basically waiting for the time to pass till you can go home! Yet everyone is in a corner talking while your staring at a computer aimlessly clicking buttons to pass the time, don't get me wrong not all the staff are that bad, there are quite a few who are awesome and fun to work with. But 60% are the former and trust me that working environment is almost unbearable!
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However of course Emma knows exactly what to say, that makes me feel like everything is completely okay! She was saying how the work enviroment where she was previously was completely different to the one we currently shared. If someone saw you were stressed or needed help they would come in look at your plan and be like your 1400 anti, I am doing it - not a matter of question it was a fact, it was an enviroment where no matter what they had your back! Basically in short form, our current ward, this clicke enviroment in full form was not the norm (thank god!). Knowing that she was feeling everything was a massive sigh of relief.
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One thing we also agreed on was the temperament of one of the other Grads I was talking about previously and something she said put things into perspective for me - She has no right to say or think those sort of things - in regards to the work and habits of us. Confirming that this grad was not as good as she thought she was and that despite her heightened sense of self worth, it was completely unwarranted!
On the plus side, 2 more months and I'm onto my next rotation! Safe to say I will not be reapplying to where I currently am but I suppose that is the beauty of working in different places finding out where you like and dislike. Fingers crossed to a better place.
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7. My First...
7th July
They say your first is the worst....I lost my first patient today. Where to start, well he was not my actual patient today, I'd been looking after this patient for the passed 3 days, yesterday in particular was horrible. I walked into my shift, 10 minutes later I'm calling a MET for someone else, followed by blood test after test, escorting them down to X-ray, another delirious patient, the med team ordering ECG, IV anti's and fluids for them without telling me only for me to read the notes, putting a massive time constraint on me. It literally just did not stop....
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Funnily enough an educator from the graduate support team came up to give me a hand, I went through where I was at and what I was doing next, she literally did not do anything....not being disrespectful, our grad program is pretty good....but she was like your on top of things and left. I was hoping she would take a few tasks off my hands however she attempted the blood cultures I already couldn't get, talked to me while I did a few more things and that was it. It was consoling to know I was doing everything right for sure, but that little extra hand wouldn't have gone astray. The day was very busy and definitely not the worsted day I have had but that brings me back to my initial patient.
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He was not the patient I had a Medical Emergency Call for, it was this lovely man. He honestly made my day the week I had him, he was so funny, I would enjoy every time I had to go in there. I remember; I had just done a few things for him and he said 'thank you, you have been amazing, you deserve a raise, send your manager in here and I'll have a word with her.' He was someone who would always have something to say and despite how unwell he felt, he always had something warm and interesting to talk about. He was severely unwell, but of all my patients he was one of the better ones, that day I hardly got to spend much time with him as I busily completed all my tasks...that I can say, I honestly regret.
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Which brings me to today, I was given a different allocation of patients, I was incredibly glad at the beginning of my shift as the day prior had been so crazy, I needed a break. Which now I'm a little sad, as I didn't get to see him, however I do not think I could have handled the death as my own patient, so I'm sort of glad that my first in that sense was one that I was not directly involved in. Long story short 10 minutes prior he was fine and the next he was unconscious, I'm in my room when the code blue was called over the system. Many of my friends have said that's how it is sometimes, you can be in conversation with someone and the next minute they are unresponsive.
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That doesn't really prepare you for seeing someone pass either, it did bring me a sense of peace, as his suffering was over. However the sudden nature of the whole thing really just shook me a little. It reiterated the importance of monitoring your patients as I could very easily have been his nurse that day, I was expecting the same allocation when I walked in, If I had been then I'd be writing a very different piece right now....
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8. Moving On
18th August
Well where to start...six months have some how come to an end. It literally felt like yesterday I was walking through those hospital doors for the first time..that dread and anxiety before every shift. Which funnily enough has now become somewhat of a distant memory as the great big whirl pool that use to be nursing, is no longer so scary. I have been going to work everyday, looking forward to and actually being grateful to score a graduate position (for a bit back there I was beginning to think, the latter would have been the better option), going to work ready and knowing that if things do turn pear shaped its manageable because I actually understand what to do and where I am going.
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If you had told me that five months ago I literally would have laughed in your face...I honestly thought I would never get the hang of things. That I would be stuck in a perpetual black hole of doom and anxiety. The quote I have had on my phone for this year...which I found, not long after I a started my Grad year, as a sort of solace for the way I was feeling towards work and currently still currently is"All things are difficult before they are easy" (Thomas Fuller).
I can now look you in the eyes and affirm that statement is 100% accurate despite how challenging and gut wrenching it has been...that yellow brick road to easy is finally in reach.
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Today was the final day of my first rotation, goodbye General Medicine. Throughout my degree, I tirelessly contemplated my career choice...reaching a point of no return where I felt leaving it would be a waste of the three years I had spent studying. So I finished my degree and applied for a graduate position, unsure of what I really wanted to do with my future and where my true passion lied. In saying that I wouldn't change the current path I'm on in a heartbeat!...the reason I chose nursing in the first place was because I really wanted to be able to help others. Whether it is seeing a patient go from worse to better, knowing I played a little part in their care or simply being able to put a smile on their face despite the horrible pain or worsening prognosis; is something I find justifiably satisfying. I have really loved the geriatric side to Gen Med, okay no I'm not talking about those elderly who continuously yell out, treating us nurses as their own personal maid but the unique and humorous old souls whom bestow their little bit of wisdom and perspective of the world.
When it comes to next year and deciding where I want to work I will always be open to Gen Med but for the start of my career, I'm reluctant to rush back at this stage. As the skill set for Gen Med is limited....I find it pigeon holing to your learning at the beginning of what will be years to come.
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The thing, I think I'm going to miss most is the people, the familiar faces I have been gracing the halls with will no longer be the same. The inside jokes and funny comments, that frequent flying patient on the ward, the smiles as you walk onto a good shift knowing that your friends are on and thus it'll be great, no matter how hectic things get. Sitting in the tea room at work and no longer feeling like the outcast, knowing the regulars and assist staff. Knowing my colleagues trust my professional judgement and when I question a clinical decision, they no longer look at me with weary eyes.
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I'm moving onto Oncology next week, which will be quite the leap out of my comfort zone. Welcome back the anxiety ridden drives to work, anxious first days, trying to find some on to check for DDs or pad changes and the many a patients & staff who will surely question my acuity as a health professional. The one thing I need to remind myself is though, how far I have come from those beginning days, if making it this far has been accomplishable....the next can't be that bad..can it?
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1. New Beginnings
30th August
Well where to start I've been at my new rotation for about two weeks now, I had intended on writing an entry a lot sooner after I started but for some reason I didn't. I'm not sure why that is to be honest, I think it may be because nothing really happened. I was kind of taking things in for the last few weeks and I'll admit I have really missed my old ward, Gen Med has become something that is near and dear to my heart.
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So my new ward, it's not terrible...but it is different. It is definitely a less supportive enviroment than I am use to. It is not team nursing orientated either. It's a very selfish enviroment. Everyone is in it for themselves and not willing to give you a hand. I thought my old ward was hard to find checks..this is whole other level. You go looking for someone there is literally no one around! You ask for someone to explain something you get a quick answer, instead of a proper walk through or example. It is just not as supportive as I'm use to, to say the least...
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So that takes me to my last couple days...it's safe to say a lot has happened. I made my first drug error...yeap that happened. I beat myself up over it at the time, and it has been on my mind everyday since, beating me up inside. And yes I made an error but it was definitely a near miss, it was an antibiotic and the patient was completely fine. Thank god!
But the outcome could have been very different if they had been allergic or detrimental with other elements of the care that was being provided to them. That was also the first Riskman I completed, they say they are inevitable but... safe to say I had to fill it out, they say their never a bad thing, but the mere idea of filling one out, let alone doing it had always been a terror. My NUM was incredibly supportive and Support Nurse never put any pressure on me at all, they only reiterated the importance of checking to avoid errors. But the pressure I put on myself was probably more than any pressure from others!
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So for the passed week I had kind of felt like a failure because of that one error. That brings me to today. Kind of on edge, but in a new room soo starting a fresh!
I started off going down to pick a patient up from theatre, I bring him up to the ward and this is when the uneasiness in the pit of my stomach began to grow. He was alert and orientated but looked unwell in every other sense, watching his vital signs like a hawk I was ready for the severe turn of event. He had multiple lines and tubes coming from here and there and his sats were not looking great, I was ready and waiting for the turn of the worst.
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Ironically, I was talking to one of the other nurses and I said, 'I have a bad feeling I'm sure of it, something is going to a happen'. An hour later, I'm tending to my guy who I'm monitoring so closely, waiting for the storm. When my other patient next door moves back into bed, next minute he is complaining of chest pain - a set of obs, an ECG and a Heart rate of 130 later...its time to call a MET call. Now when I say this is the first MET called I've ever called, I mean this is the first MET call I have ever called! I went to my NIC she was like yeap thats MET criteria have you done an ECG - I go YEAP - next thing she says is that is in MET criteria. No shit sherlock that I knew that...and she went on break.
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I went back to patient, just to affirm that heart rate was still sitting at 130...I had silently been hoping my eyes were deceiving me, but ohh yeap no it still was. So yeas, I picked up that phone called switch and the next thing I heard was my patient being called over the PA system. Next minute...not one nurse on the ward comes running into the room to help...not one....I wheel the resus trolley into the room and stand alone starting to scribe. Patiently waiting for the Emergency Team to arrive.
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Just to give you some perspective...every other MET call that has been one of my own patient. The other nurses on the ward come running. Asking to lend a hand and basically running the MET for me, as they are aware that as Grad's we are less experienced.
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But back to the current scenario here...I am standing alone in a room with my patient. About 5 mins later one other nurse arrives and goes 'is there no one else here'...no there is no one else here, clearly evident by the stampede of people around me. She stays thankfully, a few seconds later all the Doctors arrive. And for the first time, I am the one telling them why I called it, what's going on and what we have been doing. The Dr. asked as soon as I walked in, can I get an ECG. I hand him the piece of paper of which I had already done and continue to be actively involved in the MET. Which I will say is the first time I have been that actively involved I my own MET call.
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The next hour and a half left of my shift was a whirlwind of completing bloods, assessments, obs and tending to those two other patients, plus the guy who I thought was going to be my unending doom. Funnily enough he was not even the one I called the MET for. Finally trying to find the time to write notes on all my patients, while keeping up with the momentous pile of tasks that had now fallen on my plate. (Now can I say, on my old ward. After having a MET call, multiple nurses would be coming up to be offering a way to help, anything they could do to help alleviate the pressure....that is not what happened in this scenario...all those things that needed doing...yeas I was expected to find the time to do them, before night staff arrive and complain about the momentous annoyance it is that they are going to have to actually do some work.) But some how don't ask me how, but I did it. All those things, everything on my own, I managed to fight my way to complete everything. AND I DID IT.
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I think the fact that despite the lack of support, I pulled through...which is what is giving me a sense of euphoria at the moment. Until the next fail....I'm taking that as a win!!
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2. Small Act of Kindness
12th September
I would be lying if my shift today wasn't one out of the fiery pits of hell!! All four of my patients had something going wrong, spending most of my days on the phone to doctors followed by bloods, scans, antis, fluids, tests one after the other as I played duck duck goose from patient to patient - on my new word where help-is nothing but a non existent notion.
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But that's not the reason I found myself at a sudden impasse. I was looking after this patient who had just travelled overseas, soo safe to say the contact precautions were incredibly high. I basically spent the entire day taking off personal protective equipment to put it right back on a second later.
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She was incredibly sweet, she certainly made going in there worth it. I had just started a conversation with her while I was doing a set of observations when I felt something pushed into my hand. It was a $50 note, she pulled the old waiter slip manoeuvre, with a finger to her lips as a sign of silence.
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Having worked in hospitality for years throughout my studying years, being left a $50 usually warranted a high-five. However I found myself in a place of conflict, as the idea of taking money for my nursing care seemed inhumane. Don't get me wrong there was a split second there where the idea of accepting was gratifying and incredibly humbling to know, she valued my care so highly!
We then went on a back and forth of please and sorry no, I cannot accept with her trying to find ways to hide it in my pockets!! Finally I managed to put the money on her table out of reach, with a proclamation of exhaust on her part 'you make me upset now'. Having to reiterate her act of kindness, with my gratitude and impropriety it would be to accept.
Which got me thinking, now do not get me wrong - accepting monetary gifts is against hospital and nursing policy/conduct as it appears an abuse of power among other wrong doings. Safe to say thats the reason the nursing stations are usually filled with chocolate & flowers.
But I could see the frustration my refusal had caused her, she was disappointed I would not accept her means of a thank you. I reiterated to her thanks and kindness was more than necessary, but I understand the notion of wanting to be to repay someone for the care provided.
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The thing that I couldn't quite wrap my head around was that someone would offer me money in the first place...this was my responsibility to provide care to my patients...and they idea of being given money as if it were something that was owed to be is just foreign. I just shocked that anyone would give me money as a nurse, it was just something I never thought would ever happen....
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3. Nothing Natural About it...
--th November
What a shift.....I have had to deal with death before but never so graphically. I funnily enough always regretted not being there for my Nonno's final moments, but I can say with solidarity, I do not know if I could have handled it with someone I loved so dearly. And ironically....the hospital he passed away in, is the one I currently call home, which is another blessing in disguise I suppose, I do not walk the halls with the distant memory of him, as he moved hospital in his last days and I never saw him at the latter.
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So safe to say today brought up some emotions I hadn't dealt with in a while! Today it was my patient, they were Palliative soo it was not a huge shock, but it doesn't make it any more the easier. I had never seen anyone come to so slowly and painfully. Our aim as nurses is to make patients as comfortable and pain free as possible, but the things I saw in those last moments I do not know if it will every properly leave my mind. And yeas for those pessimists who say this is probably only my beginning as it gets worse in the nursing career.....your probably right...but some how I think the first time your really exposed to that is different.
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My hat goes off to the nurses in Palliative care, doing this on the daily takes a special kind of soul. The thing I seem to be struggling with a little is.....the drugs.....they are yes there to end agony and pain...but a part of me feels like we are the ones pulling the trigger as we give meds that ultimately help the body shut down.
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Arrhhh I dont know....there really is that part of nursing and it is not to so widely discussed about, but what happens after. Who prepares the body for the family to see, that is right, it's us. You see movies where bodies are taken to morgues and it is somewhat widely presumed that that is just where they went.....but its not spoken about what happens before. We as nurses prepare our patients, so families can come and repay their respects in peace.
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And the families....that is where my pain truly lies. Watching the sorrow and agony that follows. Being the one that tells the family that these next moments ahead, as they watch their loved one deteriorate are a natural progression.
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4. Routine
5th January
I was just looking at the number of posts i had this rotation compared to my first...its currently sitting about half the quota.
I guess its a good thing really, at the start it was more of something I started to be able to look back on, yet it slowly became a way of venting my work frustrations. So I pose my lack of posts in that regard is a positive thing, as the my graduate year soon comes to an end, so does uncertainty and angst.
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I currently just finished the dreaded 7 shifts in a row, this is probably only the second time I have done that many in a row, but you do get into quite the rhythm by the end of it. Working on the same ward, you get to a point where that meany days in a row, you know nearly every patient.
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I know a lot of my colleagues prefer to be given the same patient allocation, this last week I found I was moved around a little bit, more based on coincidence of late/early shifts depending on where others were last and then everyone else being allocated accordingly. But I quite enjoyed the variation and the added bonus of not being plagued by the same allocation particularly if its a heavy one.
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But it was nice, by the end of the week, I knew most of the patients on the ward. Why they were there, familiar faces on the ward and giving a helping hand to others was easier too. By the end of the week, there was a definitely a continuity and rhythm to by shifts and it felt peculiar but also very reassuring. I was like a silent tap on the back. At the beginning your constantly thinking, what needs to be done, what I need to do next, what if this, what do I do? Those questions are still there but their less fleeting cose I know what to do now.
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I use to think I would never get the hang of it and despite the fact I have plenty still to learn, its feels like I can say with confidence now that I at least know I'm heading in the right direction.
5. Heavy
19th Janurary
Code Blue. I had never seen a patient intubated until today. I had also never felt so helpless.
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I walked into work today, not sure what to expect, at first I thought this patient was going to be a nightmare because all I could hear was him crying out because of the pain down the hall - the doctors were in there at the time I might just add. Not at the point here of trying to sound like neglecting a patient's pain but unreasonable is the one word that comes to mind. There is a reasonable way to express pain and know that we are here to help elevate it.... and they way they were going about it, certainly wasn't it!
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So the doctors ordered pain relief ++ to take them out of their misery - at this point, it was safe to say sleep had become the appropriate means of management. He was no longer crying in agony, but now a deep sleep was the case - there are those patients you just have feelings about and vital signs become your saving grace. I took vitals hourly so that reassurance was on my side.
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Their resp rate was sitting below 10 and with the narcotics it came at no surprise. The medical team were aware and continued monitoring where the only thing on the cards for the time being. The family called me in to reposition them and thats where things turned. I took one look and know, our resps were my first question, they were so slow I could hardly see and we were quickly desating - it was evident things were about to take a turn for the worst. It was a blessing the Doctors happened to be right outside as things quickly changed.
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We called the MET immediately, which pretty quickly upgraded to a Code Blue. They never completely stopped breathing but resps probably would have been like a 2-3...CPR was a necessity. The Dr's all started and all the emergency team came rolling in. They probably only did CPR for like a minute but it all happened so quickly. As all the teams come rushing in, all with their own specialities, you feel completely inadequate and wish you could be doing more. You turn into the runner, going to get the baton only to hand it to them, as they need it.
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They ended up in ICU as the care needed was far greater than anything we could offer on the ward. The MET call itself probably went for nearly 2 hours...as they stabilized the patient. When I say the room was a war zone when they all left, its not an under statement. Oxygen lines, open packets, IV trolleys, pillows and blankets all quickly thrown aside.
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The only thing that has been on my mind since was maybe I should have done more, if I had done something that could have prevented all this that happened. But that's the constant battle of this job, that is now my profession - there is always going to patient deterioration and the only thing we can do is be there - provide care and escalate it accordingly.
6. Finished
2nd February
A year ago I thought this day would never come...I remember thinking on my very first day how I wished I was one of the grads that had just finished as opposed to just starting as the daunting process begin.
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I sit here now as the latter....my year has been and gone and the time has flown. It literally just flew passed in the blink of an eye, no longer the novice those many months ago.
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I can honestly say, I have learnt so much this year. Looking back the number of posts second rotation are half of the first...the emotional turmoil that often gets me up writing is notably less...thankfully. When a shift gets crazy I've always been able to turn it around by the end of it and catch up.
Walking into work doesn't bring on the nervous feelings in the pit of my stomach...there are often pangs of frustration after a crazy shift but the sheer uncertainty is definitely a thing of the passed. That feels kind of weird to admit. Hanging up the 'I'm a grad nurse' title, twas the blankie I would hold close when things got tough.
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I honestly didn't even think I was going to get a grad year to begin with. I missed out on first round offers and my fate I thought was perpetually doomed, I wasn't sure what I was going to do, that possibility of working in a hospital was soo far out of my reach and especially not my number one pick.
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Fate however intervened, I got a call from one of my top 4 as they said they had a few more positions to fill (positions which were not mentioned on the unmatched list, I might add) I went in for an interview and later that very day, I got offered a position.
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Soo grateful is an understatement...all the things and stuff I have been exposed to this year has been beyond invaluable.
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What now though, I'm not entirely sure.
I don't know where in nursing I want to go nor do I have any inkling into what area I want to work....so I'm continuing at the same hospital but moving between wards, till I figure out what I want to do. Who knows were things might end up?
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