After this week, I will no longer be a night nurse.


After five years of working night shift, I am finally making the transition back to days.  I started on nights when I was still a pretty new nurse.  I was young-- 23--and my body made the transition fairly well.  With the exception of a sleepless night here and there, life on nights was pretty awesome for awhile.  In fact, I was sleeping more than I ever had before and I was loving it.


Toward the end of 2014, anxiety and depression weaseled its way into my life, manifesting in extreme insomnia.  Although the anxiety/depression somewhat dissipated, the insomnia never went away.  For a year and a half I lived on restless, broken-up nights and days of sleep.  Never getting more than 3-4 hours at a time, 5 if it was a good night.  The very occasional long night of sleep was never enough to make up for it.  I was on my way to a nervous breakdown if I didn't do something soon.  I describe it as feeling constantly on edge.  Anxious when I went to sleep because I was afraid I wouldn't sleep well.  Anxious when I was awake because I was so beyond exhausted I could barely function.  I was miserable.


I finally caved a couple of months ago and went to the doctor to be put on something to help me sleep.  Nothing strong, but I had tried everything in the book up until that point.  That first night I woke up after eight full hours of sleep was heavenly... I remember feeling better than I had felt in over a year.  Finally I had to make the decision that it's best for my health that I go back to day shift.  Even though I'm now sleeping well at nighttime, in between shifts is still iffy.


I can't do it anymore.  I can't manage switching back and forth.  Even while my sleep is better than it was, I want to feel better all the time, and not just on my days off when I'm on a "day schedule."  I'm tired of trying to stay up late the night before work, getting in a good nap the next day, and then trying to keep myself awake all night that first night back.  I'm tired of having low energy.  It is a tired that cannot be explained.  It is being drained of all energy, legs heavy.


I've known for at least six or seven months that this switch was coming.  I am nervous to make the switch, nervous for a faster-paced environment in a facility in which I am still new.  Here's to new change, and hoping that it will be for the best!

Being a Nurse

There are times I am very weary of being a nurse.  Not tired of it, not hating it... just incredibly weary.  Stretched too thin.  Moments come when you feel so inadequate.  Like you are making no difference in the lives of your patients.  And not in a self-centered way of making yourself feel good about the difference you're making.  But I mean truly going home at the end of the night and knowing: my patients are better off because I took care of them.

And today, I just don't feel that way.  I feel like I failed my patient.  I had one of the hardest, most horrible events with a patient last night.  And I can't go into details because of HIPPA, but I will just say I walked away from the situation feeling like utter shit.  Feeling unsettled.... uneasy.  It's been a long, long time since I've felt this way.  It shook me up so much I actually had to call out of work for a personal day.  I don't do that.  But I did it tonight.

Usually I can go home and resolve the issue in my mind.  Leave it at work where it belongs.  I couldn't this time.  I spent the remainder of my night carrying it like a burden.  I carried it home with me today, and just couldn't shake it.  I still can't.

This job is hard.  No.  It's worse than hard.  It's IMPOSSIBLE.  It's not just going to work and being stressed all the time because patients and doctors and family treat you like shit.  I have LIVES in my hands, and while I am well aware of that every single day I walk through those doors, there are days that that reality slams into you.  I carry a license, one that I spent four years of college earning, almost six years since then protecting it every day on the job while trying to give the best possible care to my patients... and in the blink of an eye it could be gone.

The thing is, I love being a nurse.  Being a nurse is quite possibly one of the most defining things about me.  But today, I am just so incredibly discouraged and weary.

thoughts

I've just finished working the last six out of seven nights.  I am so beyond tired, I feel sick!  Honestly don't think I've been this tired in a long, long time.

Not only was this week one of the roughest schedules I've worked in along time, it also was among the roughest several nights I've worked in a long time.  It's very rare that work brings me to the point of tears, but this week I found myself at that point several times.  I can think of some of my most overwhelming nights, and these went beyond that.  Finally at the end of the week I had to ask the charge nurse to please change up my assignment for the last night.  Thank God last night was actually decent!

We got home from work this morning and the sun was shining and the sky was so blue.  I was tired but wanted to be out in the sun so badly so I decided to go for a run anyway.  Turned out to be a bit of a mistake as my body completely rebelled the last two miles out of exhaustion.  But at the end I still decided to walk another mile, because the weather was just too beautiful!

As I took in the scenery around me (for the first time WITHOUT snow) I became really overwhelmed by this whole experience.  All the places I've gotten to see, the new experiences.  And just how wonderful this particular assignment has been.  I know that I might not ever get to experience one quite this awesome again.  The location, our housing, co-workers... everything has just been amazing!  I feel really attached here, and it's going to be really hard to leave.  I'm actually really sad to be leaving Spokane behind.  I'm trying to remember that there is a reason for it.

I'm off for the next four nights... SO ready for a break!

Spokane, WA

Hello from Washington!  Actually, I'm living in Idaho but wanted to say that since Washington is where my assignment is.  I've been here a week now, and I have to say that I have loved every minute of it so far.  Yes, even my nights on the floor.  This assignment has already gone so much better than the first one.  I don't think we could have asked for any better, honestly.

We arrived Saturday night to snow and ice EVERYWHERE.  At first I was thinking, "What have I gotten myself into!?"  I honestly didn't realize that Spokane has quite this extreme of winters.  But once I got through that first night and invested in a good pair of boots, things have been great.  We have had snow a few times and gotten the experience of driving through it.  It's been interesting but I'm learning. I'm hoping to get to make a snow man tomorrow!

So things are going very well, and I'm very optimistic right now!  Here are some pictures from our first week here.

Our sadness of leaving Philz behind in San Francisco was quickly alleviated when we discovered we live close to THREE Dutch Bros! 

I am so excited to be living somewhere with snow!  Definitely a dream come true for me.  We'll see how I feel after a little while. 

Just playing in the snow. 

Snowy trips to Target 

In my neighborhood.  Right on the edge of the mountains! 

Getting to work with Bela has been a blast!  We have been given the exact same schedule for this assignment, which I still can't believe.  It's nice to have someone there with you to keep you laughing.  Working night shift can actually be quite isolating so it helps to have a friend by your side.  Castro Valley was difficult at times because I didn't have that.

And today, I took my first run in the snow!  I feel pretty proud of myself.  I bought Yaktrax, which make all the difference.  You can run on packed snow and ice (carefully, of course).  This weather will not defeat me!

Castro Valley

We're now down to less than two days left here in Castro Valley.  I can hardly believe it!

I started out on this journey with a lot of excitement.  Trekking across the country, stopping at awesome landmarks throughout the West, and coming to a whole new place I'd never been to be a travel nurse.  It all seemed so exciting, and it was!  But once we got started into the reality of it, it was really hard.  Throw the Holidays into the mix, and it made for a pretty difficult first month and a half.  I'm not complaining or looking for sympathy-- it's just the way it was.  I never really questioned why I did this, but I did find myself wondering just how long I would last in this business.

Of course, I'm still asking that same question.  I am finding myself wishing I had a place to just settle and live.  But I still have that urge to move on, so on I go.  I'm so excited about Spokane.  This next assignment definitely looks to be a bit more of a challenge.  It actually sounds quite similar to my job back home.  I'm kind of ready for a new challenge (though I may be eating those words in a few weeks) because this assignment has kind of dumbed me down a bit.

I will miss little Castro Valley and the rest of the Bay Area (I heart SF).  Highlights include visiting Muir Woods, Golden Gate Bridge (duh), walking the hills of SF, getting lost in the city, and eating at lots of new and different restaurants (Source--vegetarian--was my fav!).  Perhaps more than anything, I will miss Philz Coffee.  Oh, Philz, why can't I take you with me?  As for Castro Valley, I'll miss our little apartment we called home for three months.  I'll miss late night dinners at Shari's Pies.  I'll most especially miss my walks and runs around Lake Chabot.  I blew off a lot of steam on those trails, and got into the best shape I've been in for a long time thanks to those ridiculous hills!  Spokane, I'm ready for you!

Quite possibly the biggest highlight of them all would be Allison visiting for week a couple weeks ago!    We had so much fun.  I even got to do a few of the touristy things a second time, plus some new fun experiences as well.  It all just worked out perfectly with my schedule and hers.  Now she has to come to Spokane!

It's already been such a great growing experience.  I can't wait to start the next one!

life of excitement... or, not

I keep getting on here to give some sort of an update, but every time I just feel like I have nothing to say!  Life has settled into a (very) normal routine here.  And so unless we are on a rare day in SF, there just isn't much to update on that is very exciting.

I've even gone fifteen minutes since writing that paragraph and can't think of anything to say.  So, I'll just go with a really boring, update-you-with-my-mundane-life kind of post.  Gotta satisfy the readers, y'know?  ;)

I feel like I work, eat, and sleep, then do it all again.  That's the cycle my life is in right now, and that's ok.  They have taken to canceling me at least one shift out of each week, but even when they do it doesn't really benefit me much since I have already slept all day long in preparation for work.  So the cycle still feels the same.  They did cancel me tonight, which is of more benefit since I am off tomorrow as well and now have an entire day to do with what I want!  Christmas shopping, it is!

We haven't gone into SF since the last time I posted about it.  It kind of sucks to be in such close proximity to an awesome city like that and not be able to go in very much.  But we have our fingers crossed that maybe Bela will get canceled tomorrow, and if she does we plan on going into the city!  Typically if we get days off together, it's after I've worked all night and have had to sleep a good deal of the day.  So we usually go see movies.  So far we've seen Thor, Ender's Game, Frozen, and Catching Fire (twice).

So my time lately has been spent watching a lot of Netflix or Hulu.  I was excited to find season 7 of Doctor Who on Hulu!  Now I know what I'll be doing tonight!  Since, y'know, I slept all day, drank three cups of coffee, and THEN got canceled.  Ah, the life of a night nurse!  You gotta love it!

Finally Seeing SF

Well, tonight it's back to work.  But I've had a good few nights off.  The first day, as it always is with night shift, was spent mostly being lazy in front of the computer with Netflix on.  Yesterday Bela and I decided to drive my car into San Francisco to see the Golden Gate Bridge, and visit Muir Woods to see the Redwood trees!  Definitely one of the coolest experiences I've had yet!

^^^Just driving through SF, I thought all the wires were really interesting.

 ^^^We went to a cool place called Fred's Coffee Shop in Sausalito.  Here is a spinach and feta cheese omelette with potatoes and toast.  Delish!

^^^We went to Muir Woods and got to see the Redwood trees!  Something that has always been on my bucket list, and I'm glad I can cross that off!  I think I'll definitely go back to see them again sometime.  Beautiful.  And so quiet and peaceful. 

^^^We got to see the Golden Gate Bridge!  We walked about half of it, and drove over it as well.  Pretty cool!

We went to a cool coffee shop called Philz Coffee.  Not the greatest service, but I think I had the best coffee I've ever had in my life there.  It was called Philtered Soul.

So, things with work are still pretty stressful.  I'm still really anxious about going in tonight, and have had some interesting and somewhat unpleasant experiences with some of the staff there.  But we are definitely trying to make the most of our days off, and that is honestly what travel nursing is about.  We knew it would be stressful going in... maybe not quite as stressful as it's been.  But we definitely were preparing ourselves for the worst when we started this.  Somehow it has still been more stressful than I expected.  Anyway, after tomorrow night I'll have completed my first full week on my own, and maybe I'll feel better about things then... we shall see.

Settling into Life Here

I've now had two nights on the floor by myself off of orientation.  Things are still hard.  I do feel like I am figuring out the charting, but I am really missing the support system that I'm used to at my old job.  Not to mention I still haven't felt like myself back on the floor.  I know I am a good nurse.  I have been told that by many people, yet since starting out here in California I have just felt really off.  I don't know why, but I just don't feel like the old Nurse Nat when I'm taking care of my patients.  Not that I'm being a bad nurse... I just don't feel like the good nurse I know I am.  I'm hoping I start to feel like my old self soon...

I've been really trying hard to leave the stress of work at work.  I actually had gotten really good at that back home, but out here it just seems to permeate everything.  So, I'm working on that.  Bela and I work mostly opposite schedules, which hasn't helped since often when I'm off she has to work.  We did both have yesterday off, so we took the evening to set up our Wifi (THAT was a whole fiasco in and of itself!) and went out to dinner at Fuddruckers.  We were both craving a good burger.  Since we have been making fires in our apartment most nights cause of the cold, we decided to make s'mores last night.  Delish!  And after FINALLY getting the Wifi set up, we watched Parks and Recreation on Netflix.  Yes, I have gotten Bela addicted to it.  Best show ever!

Here is the delicious s'more I ate last night. 

On my walk this morning, I decided to walk an extra large hill.  The hills here in the Bay Area are killer, but the views are beautiful as a result!  Totally worth it!  Not to mention I'm getting into better shape.  Hadn't been doing too great of a job since traveling out here with my eating or my exercising.  And I just feel like crap when I'm not eating right and exercising.

 There's a part of the trail I walk that I think looks like an enchanted forest.  I took some pictures.

Doesn't that look like it belongs in Narnia?

So overall I would say things are going well.  Of course I'm stressed, but I'm working on that.  I have been a little homesick at times.  Just for familiarity of home.  I never thought I'd miss my home town, but at times I do.  Though I know I will probably never live there again, it will always be home to me.  But I am loving being in a new place also and exploring it.  Tomorrow we plan on taking another trip into SF, this time hopefully to see the Golden Gate Bridge.  The weather has been pretty rainy since yesterday though, so hopefully things will work out.

A little better today...

Things are looking a little brighter today.  I thought that with yesterday's somewhat depressing post, I'd better write another update today so nobody is too worried... ;)

Yes, it is still hard.  Part of why I feel better is I've also been off of work the past two nights.  Tomorrow night I have to go back in and be on my own on the floor.  Honestly, the biggest issue for me there is that I'm completely new to this system of charting.  I'm just not used to it.  The patient care is the same, of course.  But when you can hardly figure out the computer system it just puts you behind on everything else in general, which makes it really hard.  Not to mention the support system just isn't the same for a travel nurse on the floor as it is for a permanent nurse on the floor.

Anyway.  Yes, I've been off today.  Bela had to work tonight, 3-11:30, so I am currently sitting at a coffee shop (Peet's Coffee and Tea... nice to have something besides Starbucks!  Though I do still love Starbucks...) for internet since we still don't have any at the apartment.

I took a really nice walk today.  A couple of days ago on a walk, I decided to go a little bit further and discovered a beautiful park with rolling hills and beautiful views.  Today I decided to walk that park.  Let me tell you, a walk sounds like a nice, leisurely activity, and it was to a point.  But those hills were KILLER!  I've never walked anything like that before unless it was a hiking trip.  Not to mention the weather here is just cold all the time.  By the end my hands were numb and I could barely move them.  I decided that I needed some warm workout clothes (never needed that before), so I found some nice fleece jackets at Ross.  Gonna need to get some gloves too... definitely wasn't expecting this kind of weather in California!

Thankfully, things are looking up today.  I know that's easy to say when I'm relaxing in a coffee shop, and we'll see how I feel tomorrow when I'm walking into work at 2300.  I'm praying for it to be not so overwhelming... we shall see!

This has been a really rough week.

Reality is definitely setting in.  We got our furniture delivered to our apartment this week.  Now it feels like home.  But things are settling, and we are definitely feeling the reality of our situation.  We have finished our two whopping days of orientation on the floors we will be working on, and both feel so inadequately prepared for what is to come.  Especially Bela, as she has to work day shift and it is SO much crazier than nights.

Travel nurses are just not treated very nicely.  I knew that before going in, but I just didn't think it would be this hard.  The expectations are incredibly high (this is why you should ALWAYS make sure you have plenty of experience before starting) and the training incredibly insufficient.  The charting is different than anything I've ever used, and I have to learn that on top of learning two whole new units, dealing with new co-workers, and charge nurses in general who just don't give a crap about how you're doing.  Because although we are here to help the hospital out, we are essentially on our own.

Anyway, outside of work I really love it here.  We have met some really wonderful people, who I think will be so helpful in helping us to not feel so sad about our circumstances.  I think we are also just going to have it rough for a couple of weeks until we get a little more acclimated to things.

Right now we are just sitting in Starbucks drinking our peppermint mochas, listening to the cheery Bing Crosby music in the background, and trying our best to be positive about things.  I do think that things will get better... it's just gonna be a rough road to get there.

I'm in California!

Hello from California!

It has been a SUPER DUPER BUSY week and a half.

For a better update than I can provide here (and mainly for lack of time, as I'm currently sitting at a cute diner called Shari's Pies since I have no wifi), I will send you over to mine and Bela's blog about our travels.  Right HERE! (The link is also on the right side of the blog under blogs I follow, in case you want to just follow that blog.... between Bela and I, there will probably be a lot more detailed updates there!)

I will say that California has been so different than anything I ever expected.

We have run into the kindest, friendliest people ever.  And we are from the south!  I feel so lucky to be where I am right now.  It is definitely really scary, but it's where I'm supposed to be.  And it's not been a walk in the park, either.

We finally got settled into our apartment today.  It really hit me then.  This whole last week and a half have seemed like whirlwind of excitement, travels, new job, meeting people, etc.  Then we got to the apartment, things were quiet-- and I looked around and realized this is it.  I'm 3000+ miles away from home.  And I felt homesick, I really did.  It passed after a few minutes, but I know it will come and go in waves over the next few weeks.  Especially as the Holidays are approaching.  Thankfully I have my best friend Bela here, and we can both be homesick together and hopefully cheer each other up.

With all of that, I still know that I am in the right place.  That I'm where I'm supposed to be, doing what I'm supposed to be doing.  And I'm scared.  This new job scares me.  It will be very similar as far as the nursing bit goes, but their computer charting system is incredibly daunting and something I will have to learn very quickly.  Any prayers and good thoughts are appreciated.

I will try to be back here more often for updates.  Here's hoping for a great first full week of work, and meeting more great people!

Soon to be a California Girl...

Well, the day has almost arrived.  After a super stressful two days of paperwork-gathering, immunization-getting, shopping, and packing, the day has finally almost made it here.  Honestly I thought we weren't going to get everything done in time and we wouldn't be able to go.  We had that much paperwork to do in such a short amount of time.  But it got done, thank goodness!

In the morning, Bela and I are packing our things in my car and starting our drive to California.

I am so excited for this opportunity.  Honestly, I don't think that the reality has set in.  At all.

It's like I'm just going on a really cool road trip.  Not traveling to a place where I'll be staying for the next three months, and then after that on to another place.... it just hasn't registered yet.

Would be thankful for any prayers, good thoughts, etc, as we make our drive this week!  It'll be a whirlwind!

Exciting Changes

It has been an eventful past ten days.

First of all, I got back on Thursday from a 4-night Bahamian cruise on the Disney Dream!  What a blast!  I will eventually post pictures, but that isn't even the half of what has been so eventful.

I have kept it pretty quiet, but since July I have been pursuing travel nursing with my friend, Bela.  I got my California license in September and began the process of getting my ACLS certification.  We got in touch with a travel nurse agency and began the process of sending our information, speaking with our recruiter, and submitting ourselves for assignments.  That was a process, let me tell you.

We got offered a job about ten days ago in San Leandro, California.  We were SO excited.  We would both be working evenings, 3-11:30.  We both put in our two weeks notice, told them our date we were available, and waited to sign our contracts.  This time period was when I left for my Disney cruise.  I had planned to check my e-mail Monday night to see if there was anything else I needed to do.  We found out that day that San Leandro was out of the question because they would not negotiate the start date and needed us out there a week earlier than we could get there.

We were upset, but we both contacted our bosses (I had to e-mail mine) and worked out getting off a week earlier.  All this time in the back of my mind, I was thinking we were screwed if things fell through.  But all they needed was for us to be there earlier, so we thought we were in the clear.  Only to find out the next day that they had pursued other candidates and we had missed the boat.

Needless to say, I was really upset.  I felt like here I had not only quit my job, but I had quit a whole week earlier for something that completely fell through!  We spoke with our recruiter and she very diligently kept looking for jobs, but nothing seemed hopeful.

One popped up in Castro Valley, California, however.  It wasn't really the ideal situation compared to the other one, but we asked her to go ahead and submit us.  We found out that I had the wrong computer charting experience and they required me to have one I had never used before.  However, thanks to my recruiter, by the end of the day we were both given offers and now we are set to leave this Wednesday for our first travel assignment!

Let me tell you, it has been a major emotional roller coaster.  From excitement for a new job, to the low of the prospect of unemployment (which, let me tell you, were a really rough couple of days), and then back to more excitement-- it's about been more stress than I can handle.

Because it was all so last minute, I didn't get much of a chance to say good-bye to my co-workers.  Or really even much closure as far as work is concerned.  It's like I was employed by them like always, then went on vacation, and came home and worked a few more days.  And now I'm done.  It's hard to believe that after four years of working there, that's it.  I will definitely miss my co-workers.

I have so much packing, paperwork, and last-minute shopping to do.  It's definitely more than a little overwhelming.  Hopefully by Wednesday, we will be all set to start off on our first travel assignment!  Can't wait to tell you all about it here!

A Great Week Indeed!

I am coming off of a great week!

First of all, I finally, after four years of being a nurse, got my ACLS certification!  That stands for Advanced Cardiovascular Life Support.  I feel all nursey and ready to save a life now!  Just have to keep myself refreshed on the material so I'll remember it.

Second, I spent a few days in Orlando at Universal Studios with my wonderful friends Bela, Priti (and her husband Brad), and their mom Miss Gita.  Bela is my best friend from nursing school, one of the few I've kept in touch with.  She has become one of my very best friends for life, and we had such a great time hanging out in Orlando!  I was sad to come home, but there are always lots more good times to come!

We picked a great time of the year to go.  The crowds were minimal (for a theme park) and the weather was hot but not too hot with very little rain.  You can't win with Florida weather even in September, so you take what you can get.  I have to say, after this week I can finally say I love Universal Orlando.  I am a Disney girl through and through, so it was difficult for me to love Universal even though I've been three times before this.  I was always comparing it to Disney in the past, but I think it takes being with the right people to learn to love something like this.  I had a blast!

Here are some pictures from our time there.

 The first night, at the hotel getting ready to go to dinner.

 Me and Miss Gita, Bela and Priti's mom.  One of the most genuine, sweet ladies I have ever known!

 A pretty typical moment for us.

 Enjoying yummy nachos and queso.

 Miss Gita, Bela, and me.

 All aboard the Hogwarts Express!  The conductor declared us to be his wives, upon which Bela and I were excited to discover we are now sister wives!

 Flying brooms.  Or trying to.

 In front of Hagrid's Hut

 On a ride (similar to Teacups at Disney) with Miss Gita.  I got called out over the loudspeaker on this ride to put away my cell phone.  It was worth getting this picture!

 Hogsmeade.  Wish this was a real-life place!

 I feel like I could join the Ministry of Magic with this hat.

 Just goofing off

 I've always wanted to take a picture with these since the first time I went to Universal.  So we took one.

 Getting photo-bombed by a t-rex

 We went to the Animal Actors show.  It was pretty cute!

 Just before the Despicable Me ride.  It was one of my favorites!

 We got to meet Lucy Ricardo!  She was slightly drunk.

 We had tons o'fun at Universal Orlando!

Our last meal out before leaving at Pastamore at City Walk.

Ok, I have held off on watching Duck Dynasty for awhile now.  No particular reason, I just didn't watch it cause it didn't interest me.  Now I think I have jumped on the bandwagon.  The other night when I was canceled from work, I turned on the TV for background noise and came upon a Duck Dynasty marathon.  I watched it for three hours straight.  I can't believe that this show sucked me in!  It is hilarious, and everything Si says makes me laugh.  Anyway, it's a funny show about a family that seems really close and loves and respects each other.  How can you go wrong with that?  (SN- despite the long hair and beards, these guys are still pretty handsome!)

So, I picked up an extra day of work this week since we've been canceled so much.  I figured if they canceled me this time around, hopefully that extra day would help make up for it.  Sure enough, I'm canceled tonight.  I was kind of glad, actually, because I was charge nurse last night and it was particularly stressful.  We had to support team a patient and it was so much more stressful than when I'm the floor nurse.  I'd rather have my own patient support teamed than to be the charge nurse during someone else's support team.  It was particularly frustrating, too, because of the stress of dealing with co-workers when you're in a position of leadership... it is just really frustrating.  Left work this morning feeling really discouraged about my job.

Being a Nurse

Work has been kicking my butt lately.  I've tried to refrain from talking about work in general when I'm not there because, well, it's just depressing.

However, I've noticed there is a large number of people who are interested in nursing.  From young girls (many of whom I honestly believe will pass out their first day on the floor) to adults going back as a second career. And though I encourage people to follow their dreams, I think that nursing is one dream that you should think very, very carefully about.  It isn't like those commercials you see for Keiser University telling you how wonderful working in healthcare is.  It definitely isn't like anything you see portrayed on television.

I've sat down and tried to do this many times- outline what a typical night at work is like for me.  That's really hard, because you simply never know what combination of patients you will get.

So I am going to tell you about a bad night I had once-- and nights like these are far more frequent than I wish they were.

I walked into work, ready for my assignment.  Four patients, open for an admission, and no tech to help me out.  Ok, I can do that, it is always a challenge but not impossible.  As I go through my reports to see what kind of patients I am getting, I'm told that another nurse has two patients she is giving blood to so I need to pick one of them up.  I basically give up one of my easiest patients to take this one, but still.  It could be worse.

As I'm getting report, my admission is up on the floor at 7:05.  Now normally, report takes until at least 7:15 if not later.  The ER tech bringing the patient up decides to be really impatient, hitting the staff assist button for help pulling the patient onto the bed.  So now the alarm is ringing through the entire floor (you don't use staff assists unless you're close to somewhat of an emergency or you need help RIGHT NOW or something bad could happen).  So I'm still not even finished with report, but my charge nurse is kind enough to go in there for me to help transfer the patient.

So, I finish report-- it's now 7:15 and I go into the room to seen a large elderly man in bed, looking like he's having a very difficult time breathing.  I'm told he's here for COPD, but he seems a lot sicker than just that.  First blood pressure reading I get is 70/46.  Shit.  There's nothing worse than ER sending you a patient that hasn't even been properly stabilized.  I take it again, and get 78/50.  Still bad, but at least I didn't hit the 60s systolic.  Patient is responsive, so I get him onto telemetry, listen to his lungs (which sound coarse, but not really wet).  I have to start seeing my other patients as well, but my priority is to get a call out to the admitting doctor for orders regarding the blood pressure.

I move on to begin assessing my other patients and checking their vital signs, letting my new patient and his wife know that I will be back in about 15 or 20 minutes to admit him, and that I am contacting the doctor.  The next patient I see has to get up to use the bathroom, so I help her up the the bedside commode.  So while she's on the commode I go into another room to assess that patient and take his vital signs.  He's pretty simple, just has a foot wound and is waiting to have surgery.  Thank goodness he'll be my easiest one that night.  Back into the other room to help my patient off the commode and back into bed, and I take her vitals and assess her.  I already can see she will be pretty needy as far as calling nonstop.

So will my patient who is also getting blood, because she can't get out of bed with all the IV tubing and pump and still walk without tripping.  The last one, a total care with a G-tube, wound vac, multiple ulcers, and bad diarrhea.  At least she's stable though, and I shouldn't have to change the wound vac tonight (talk about a long dressing change).

So the nurse practitioner calls me back at this point on my admission, and I let her know that the patient came up to the floor with low blood pressure.  Immediately she wants to know a lot about this patient, and I tell her I literally haven't even admitted him but that I just wanted to address the blood pressure with her before moving on.  I let her know that his lungs sound ok, so she orders a fluid bolus and then continuous IV fluids, telling me I need to notify her if he sounds like there's any fluid overload.  While the bolus is running I run through the admission interview with his wife.  Almost right after the bolus is finished, I notice his lungs do sound wet, and that I can't continue any more fluids.  And his blood pressure hasn't gone up any.

So I put another call out to the doctor, in the meantime beginning my medication pass.  It's about 8:30 at this point.  (FYI- med pass at nighttime is typically 9 o'clock, but you can give them a little early or a little late.  You have to start early in order to finish on time)  So after my first med pass, my patient getting blood calls to let me know her first unit is almost finished running.  So I stop it, check her vitals, and document.  She needs Lasix as well in between, so she doesn't get fluid overload since she has congestive heart failure.  I give her that as well as her other medications that are due.  But I don't have time at this point to get the next unit of blood going because my admission is still not doing very well and needs close monitoring.  He is on a 50% venti mask, and his oxygen levels don't seem to want to go above 91 or 92%.  Thankfully, though, his heart rate is fine.

The nurse practitioner calls me back at this point, ordering a dopamine drip to start on the patient.  She says that if we can't get his blood pressure to consistently stay over 95, he needs to be transferred to the unit.  Otherwise, we will give him Lasix to get some of that fluid off.  So I start the dopamine drip finally at 9:30.  I monitor his blood pressure, and it's not going up.  My other patient keeps calling me to get up to the commode, as well as my patient receiving blood who is just plain needy.  And there's no one to help, because everyone else is just as busy.  I am able to get my charge nurse to pass one of my patient's medications because I'm running out of time.

So I'm running around like a chicken with its head cut off, and at this point I know I'm probably going to be transferring my new patient to critical care, but I need to see first how his blood pressure is doing. It's still low, but now his oxygen sats are as well and his heart rate is suddenly in the 120s.  This is probably about 10:40 that begins to happen.  I decide it's time to put a call out to the doctor.  I'm up at the desk and dialing the number, and I ask the unit secretary to please read off the exact blood pressure and heart rate on the monitor so I can write it down and tell the doctor on call.  She tells me, then as an afterthought goes, "Oh, and his sats are 68%."

Shit.  I slam the phone down, wondering why she's only just now telling me this and run to the room.  One look at the patient and it's time to call a support team (also known as rapid response in many hospitals- it's basically like when you call a code blue, only your patient is in distress, has had a sudden change in status, but you aren't to the point of having to resuscitate just yet. It's to prevent code blues from having to happen.)  So my charge nurse brings the crash cart in, respiratory is in the room switching him to a non-rebreather mask, and within five minutes the intensivist and critical care nurse is in the room.  After I give him report to let him know what is going on, he says "I can't even believe this patient is on the floor.  You should never have had to care for him here.  We're gonna send him to the unit right now and intubate him."  So, now it's time to take a trip to the unit, hand off report to the nurse taking him, and leave him in good hands.  This nurse has only one patient.  I have four more I need to get back to, and now I'm open for another admission.

Back to the floor, it's after 11 and I couldn't get my charge nurse to pass my last medication pass for me while I was transferring my patient, which is now two hours overdue.  And it's the longest one of them all, because it's through a G-tube and I have to crush them to give them.  I multitask and give all the meds due now, and check her 11:00 vitals.  And now I can see she's had more diarrhea, but I need to check on my other patients before I can even think about cleaning her up.

I hang my midnight antibiotics, check my other patient's vitals.  Now it's time to hang the second unit of blood for my patient, which I should have had started at least two hours ago but didn't have time for.  Thankfully her vitals are stable, so I go down to the blood bank to pick up the blood.  I have to stay in the room with her for the first fifteen minutes to make sure she doesn't have a transfusion reaction.  Then check vitals.  She's ok.  So now the blood will run, usually it takes 2-4 hours.

So, my patients are mostly settled now, and it's getting onto 1 am.  I need to clean up my incontinent patient.  I get someone to help me, and it takes at least 20 minutes.  Now that's done.  And now my second admission is being assigned, so it's time to get ready for that.  I set up the room.  I sit down at the desk to start charting, because I haven't charted one thing yet.  If it's not charted, it's was never done.  I get some charting done, then my admission arrives.

Thankfully it's a walkie-talkie (doesn't need any sort of assistance for anything regarding bathroom, feeding, walking, etc).  So now I have to start all over with the whole admission process, great!  This usually takes an hour total.  So I finish that up.  Now it's getting onto 3 am, and time to do my vitals again.  So I start working on that.  And the blood is finished down the hall, so I check post-transfusion vitals and record them.  I've still got to finish my charting, so I begin working on that.  Shift reports, too.  And I haven't had a break.  But I work on all of that, and surprisingly I get caught up.  Around 5 am it's time to start med pass for the morning.  I am working on that, and my co-worker has a lot of patients she needs help with, so I help her.

By 6:15, everything is pretty much caught up and finished.  Day shift soon arrives, and now it's time to pass off report.

I go home exhausted, knowing I have to come back tonight and do it all over again.

You see, nursing isn't just about helping people.  It isn't just compassion, sympathy, and caring.  This narrative doesn't even begin to scratch the surface on what nursing is, but it gives you an idea.  I would love it if I could take the time to talk with my patients, and listen to them.  To take my time when I am caring for them.  But I can't.  Nursing is the stress of someone dying on you, or being reamed by a doctor because he's pissed you're calling him, dealing with angry family, patients cussing you out, demanding pain medication for their own high, cleaning up vomit and poop and mucus and urine, all while management tells you that you need to manage your time better.  This is why I tell people that they should think very carefully about nursing. 

I don't hate it, though.  I went into nursing a timid, shy girl.  And nursing has made me a hard-ass who doesn't take crap from people.  It's made me grateful for my own health, and the health of my family.  It's made me realize that people are crazy.  And it's made me realize what a capable, hard-working person I am.

So if you want to be a nurse, be a nurse.  Just be prepared for what is in store, because it's certainly not going to be what you think it is.

Also, congratulations if you made it this far reading this post.

Yesterday I had a reunion with my best nursing school (really, one of my best ever!) friends Bela.  We became friends on the first day of orientation when we happened to be in line together at the cashier's office, along with another friend Tatyana.  We ended up sitting together the rest of that day at orientation, and became inseparable for the next two years.  I remember our first conversation being about our faith, and being so glad to have met a friend who shared the same beliefs that I did.  It turned out she was living with her aunt in the same town I was, and we decided to carpool together as well.  Those car rides were what solidified our friendship over the next few weeks, but due to her propensity for not being *quite* as early as I was, we decided to not ride together anymore.

The first time I remember really feeling comfortable with her was that we had to park in the farthest parking lot from the campus.  We both bought the cheapest parking passes.  And we got these books in these huge boxes that we had to carry out to our cars, and couldn't stop laughing because they were so heavy and we could hardly carry them.  I was so glad to meet someone who laughed at something so silly with me.

It isn't often that I, as an introvert, meet someone who is so accepting of me and some of my personality quirks.  She really brought me out of my shell in a lot of ways, and has ended up one of my best friends for life.  Even though we don't see each other that often, when we get together it's like we can just pick up where we left off.  This time we have decided that we won't let so much time go by in between seeing each other.  But it is just good to know that you have friends like that.  

Catching up last night was really great.  Probably one of the most refreshing evenings I've had in awhile.  Just having someone to listen to, and you can listen back.  Here's hoping that we have more time in our busy schedules to hang out!  She only lives an hour and a half away.

Also... please excuse the horrible sense of style I had in college.  I was poor and had no money for things like clothes.  But I had a lot of fun!