Sunday, October 25, 2015

There's somebody behind the curtain!!!!

I'm giving a patient an extended-release potassium pill, which is gigantic and extremely foul-tasting. The patient is having a procedure, so can't eat or drink anything (except for her meds), so she can't chug a giant glass of water to get the pill down. You can't dissolve it, crush it, or chew it, either...unfortunately, the instant it comes into contact with moisture, it starts dissolving...and tastes incredibly disgusting.

Me (watching the patient shove the pill all the way to the back of her throat with her finger): Oh, it's like giving a cat a pill!

The patient's twenty-something daughter: It's like giving a blow job...

Me (inside my head): Only if you have a gag reflex...
The patient reaches out with her free hand and smacks her daughter's arm: I can't take you anywhere!

Me (to the daughter): Maybe that's not the best thing to say in a semi-private room!!!


Things to consider when you're in the hospital:
-even if you're in a private room: NO PRIVACY
-but definitely worse when you have a roommate: you can hear EVERYTHING, including when the other patient is shitting into the bedside commode.

Thursday, October 15, 2015


Let's see...well, the job is going well, according to my preceptor! According to ME, I'm a failure, because I'm not handling everything by myself, all the time. I know I'm new, and I know that I truly don't know very much (still), but I want to be the best damn nurse out there. Now.

I don't want to be the person nobody wants to work with. You know, THAT person. The one who always needs help and never gets her shit done. As it is, I already feel like I don't get to spend enough time with my patients, that I'm charting all the time. I've been told that as I get more familiar with the (electronic) paperwork, I'll have all that done much faster, and more time will be freed up for actual face-time with the patients. Heh, "patients"...I have patients but no patience (for myself)!

So, skills. I'm getting there. I had to give a patient six different medications via IV yesterday, and I rocked it! I was slow getting everything together, because I'm CAREFUL. All of these meds were clear liquids, you gotta be careful and organized (pretty much OCD) with that shit!

All syringes were labeled, I knew which meds were compatible with the (continuously) running IV fluids and which weren't, which meant I knew which meds could be administered via the implanted mediport, and which had to be given IV push through a peripheral IV site. I knew exactly how long I had to push the meds (generally over two-three minutes, which is a LONG time when you have fifty other things to do and the patient is getting IMpatient, even though you've explained it to him five MILLION times...).

I've done discharges and admissions. I helped administer a unit of platelets, and I'm learning to tactfully and diplomatically DELEGATE TO THE LNA. A very necessary skill, because I don't have time for all that (sometimes literal) shit.

I've given shots subcutaneously (lovenox and insulin) and intramuscularly (flu shot, that's a honking BIG needle!).

I've given patients little cups brimming with colorful pills and capsules, scary the polypharmacy, but necessary. And I've been able to tell them what they all are and what they're for.

I've done lots of patient education, about many different things. Like nutrition and portion control. Why they might be retaining water, and what the docs might do about it. And what they, the patients, might have to do at home to deal with it.

I've done dressing changes and linen changes. I've wiped people's bums. I've catheterized one poor soul. Successfully. On the third try. Hey, it's way harder to do females! Have you looked for a female's urethra lately?!

I've gotten my first, and hopefully last, needlestick. Don't worry, the "source" came back clean, so I'm ok.

I've dealt with doctors, interns, residents, and medical students. I've spoken with PTs, OTs, case managers, social workers, and pharmacists, among many others. It's all good, nobody's has ever accused me of not being a talker!

I've discovered that patients misunderstand or mishear a lot of what you say, and that they also forget a lot you've said. And sometimes they even forget that you were the one they talked to!

Along the way, I've learned that pancreatic cancer is a fucking bitch. And that Graft versus Host Disease is a VERY SERIOUS MATTER. Ugh, what a nightmare!

I've also found out that with age truly comes more tolerance. I've had to caution some younger folk, to A: talk more quietly at the nurses' station, and B: that they never know the whole story, so stop JUDGING.

Regarding my move, I love the area. New Hampshire is glorious in the autumn, truly. And I need to move as soon as my lease is up, because you never make as much (take-home) money as you thought you would, and convenience and proximity to the hospital makes my apartment too expensive for me. I have student loans to pay back!

And I finally am in a position to make my private massage business a reality. And it's perfectly legal to do so here out of my home, which makes it a lot easier for me. I have my spare bedroom set up as a treatment room, and it's wonderful! Hopefully that will ramp up as time goes on and word of mouth spreads. We'll see.

So, that's the update. I'll try to be better about posting more frequently, I see that it's been over a month! YIKES!

Yeah, I have a blog post dying in the drafts folder, since I lost the fire to finish it as the immediate urgency waned. It was about the Day of the Needlestick. It was a Very Bad Day. I had a discharge followed immediately by an admission (like, the minute the room was cleaned), and the discharged patient was the one I got the needlestick from. I was deaccessing her mediport, and the honking big Huber needle whipsawed back and jabbed me in the thumb. Right through the glove and I started bleeding like a stuck pig. Hurt like a motherfucker. Turns out there's a safety mechanism on said needle and I didn't engage it. Whoops. Now I know.

Oh, and that day was super-busy. Only my third day on unit, I never got lunch, but I did get my period. Yeah, one of those days. I had to fill out an incident report about the needlestick. And as it was a weekend, I had to wait until Monday to go to Occupational Health for an exam and blood draw.

See, this was pretty much the blogpost I had planned, so you didn't miss out at all! Except for maybe some Atomic Level Whining, so you're better off this way.

Anyhow, I'll try to post more often, but understand: When I get home after my shift, I usually just walk the dogs, eat, and go to sleep.

This weekend I'm headed back to Mass to visit and do Fun Things. Including going to my first rave. With my twins. God help me! So maybe I'll even have something to blog about!

Take care and see you on the other side!