WAH HAAAA HAAAA HAAAAAAAAAAAAAA!!!!!!!!!
Between your being blind and Cvl being stuck in some form of All-Consuming Maternihell, I've been laughing my a** off over here!!
Anywho....
Hi!
Week 1 of the ongoing series
National Geographics' Life of the New RN has come to an end. It actually came to an end on Wednesday night, but still being in 5-Year of Stress Letdown and having had a whooooole h'll of a lot of built up lactic acid to burn off, I've only really come to today. Who knows, maybe tomorrow I'll actually wake up
BEFORE noon?
I did 3 twelves, 7a to 7:30p, Monday thru Wednesday; starting with 2 patients Monday and Tuesday and getting a third, on a vent, on Wednesday. It was 36 hours of trying to make sure nobody died, everybody got clean and 'fed', everybody got their meds and their dressing changes, everyone's paperless chart was documented in as thoroughly as possible, while trying to stay on schedule with everything that I needed to do in order to actually be able to leave at 7:30 by mustering up and desparately clinging to some tiny little bit of confidence that I actually knew what I was doing in order to keep myself from just stopping to dead standstill in the hallway, crying like a woman possessed. So yeah - so far so good! *
cheeeeennnng 
*
Of the patients that I had, only 1 was totally communicative. Lucky for me and everyone else who had to take care of him, he was a whining attention seeker.
"No, I'm not going to stop hanging your declared incompetent roommate's IV antibiotic in order to come throw away your unwanted pudding cup." I got to "admit" this fine gentleman after discharging another patient to a skilled nursing facility. That was a lovely moment, finding out at 1:20 -before I'd eaten lunch- that an ambulance had been scheduled by Case Management to come pick her up at 2:00. Fan-Frickin-Tastic, my friend! Thankfully, this has got to be the most nurse-friendly organization in terms of systems management. All I need worry about was disconnecting her feeding tube, asking
Super CNA Welly to pack up her stuff while apologizing profusely for late notice that wasn't my fault, and write up a little 'Page 2' nursing note for the discharge papers. Interfacing with the EMTs, and making sure everybody else did their paperwork: Wasn't my job. That worked. The admitting process, however, that was a ridiculously long ordeal with multiple redundancies written into our "practitioner friendly" computer system. It was Tuesday that the discharge and admission took place. My preceptor planned to finished up a remaining piece of the data entry for me YESTERDAY. As far as whiny man, I got to miss what could only be the beautiful effect of the newly initiated Seroquel and Ativan orders for him. Whoever had him today, must have had a great time. It could only get better from my having to actually say a hand waving 'You know, I've got to get going; I'm going to have to let the nurse coming on know about this, so she can help you' after the final act of scratching his back and applying lotion for him, when he asked me to wash it off because he didn't like the smell. I stopped wondering a long time ago of what drives an elderly woman to murder her husband over the placement of the cranberry juice on the wrong shelf in the fridge just that one time too many. Hasn't been reported in the news much lately, but I'm pretty d'mn sure that snap killings are still being inspired out there. No one can convince me otherwise.
On the killing tip - the one low note of the 36hrs o' fun:
Darren Shiftless Lazy A** CNA. There's a word missing from this title, but certain things can't be said in the presence of a broad audience. jordan would know; last letter 'o'. Only worked with him on Wednesday. Went in to check on my incompetent patient only to find the red cap on the gastric side of his two-port gastric/jejunal feeding tube had popped off at some point between my having given him his morning meds and then. His bath having taken place in between. Odd considering it hadn't happened at all in my 24hrs with the patient before. How disappointed was I to have missed the bed acrobatics that led to the cap being under the back of this patient who's only motion prior was begging for contractures by pulling his legs up to his chest, laying in a fetal position? But alas, the moment was missed so I just set to replacing the cap and cleaning the gastric juice off of him. Cut to a bit later, need to give my dear patient his 2:00 o'clock meds through his gastric tube. Go over, lift up his sheet, his j-tube has been pulled out and letting the contents of his feed bottle just pump out all over him and the bed. Now how in the h'll???? Given that, he in his fetal ways, was quite combative when it came to trying to move him for anything. I call out to my CNA for help in cleaning him up. I say 'His feeding tube came out somehow'. His answer? 'Oh, I Know, he's always doing that'. wha whu? 'You knew the tube was out?' 'Yeah, I saw it. I don't know why they took off his restraints, cuz he's been doing that since he been here' Apparently, everyday that he's been there except the 2 days prior that I was with him for 12 hrs, hearing of no such incidents from the 3-nights of RN reports; which is beside the point because the main issue is that
You knew that the man was lying in Jevity feeding formula and #1 - You didn't bother cleaning him up, and #2 - You didn't bother telling me that the sh't happened!!!?????!!! I swear to God, if I had the authority to fire - His a** would have been leaving right then and there! I didn't even bother saying anything because I already knew he's just too ingrained ignorant to see the point. I haven't been there long enough to have some jacka** start talking me up as a b'tch to work for/with. That he can start talking up later once I'm more comfortable in the role and more established with the crew; because
HE WILL be made a miserable lazy a** sumb'tch when on shifts with me if he "works" the same way then. I don't have the patience for the decidedly lazy. Good news is that, before I saw how crappy a CNA he was, he'd mentioned to me how he couldn't wait to start working nights. You know, the shift that I'll be working once I'm done precepting? Oh lucky day

. I asked my preceptor a little later if it's well known that he just sucks and it turns out that it is. She being a form of manager (they don't really have unit Nurse Managers there), she said that she's been watching him. She plans on watching him even more now.
Welp - that's it for this week's report. All in all - I can't for the life of me imagine how day shift RNs can EVER get everything that needs to be done, actually done, with a full 5-,6- or 7-patient caseload, over the course of an 8hr shift. It seems pure madness for me to even try to believe so from where I sit! Kudos to those seasoned nurses who can actually pull it off. My new org doesn't actually even hire for 8's anymore. On Monday, I'll be spending about 4 hours performing rounds with the Wound Nurse, and another 4 shadowing Respiratory. The last 4 (told them I want to make sure to be working fulltime during precepting) kind of following and assisting one of the RNs, Gail, instead of picking up my own patients for 4 hrs. Works for me! Gives my muscles an extra day of rest away from lactic pain, too. Still surprised by that one; didn't even feel like I'd done anything to bring it on!?! d'Ah well - Time to go eat!
na