Puppet Master

I want to preface this post by saying that there may be a lot of crude humor.  I work in the medical field, specifically the EMERGENCY medical field.  If something makes you uncomfortable, I'm sorry.  Humor, crude as it may be, is a coping mechanism for the amount of stress we endure.  I would like the chance to defend my point-of-view, if you would like to comment (even anonymously).
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So, this week has been chaotic, to say the least ... but I'm used to that.  But, I do have to say that today was the best day at clinical that I've had in a while ..............

Okay, so at the beginning of the semester, we chose outrotation sites to take the place of 2 clinical shifts.  I'm on an inpatient oncology unit for my semester, so any chance to get out of it was definitely taken.  I signed up for the ER and ICU for my days.  I will get to practice clinical skills under the supervision of an RN.  I felt like a puppet master since I orchestrated today's events (mwahahaha) for the ER.  I cursed myself so I would get a good learning day ... and I enjoyed every minute of it!

I called my friend, "E," at the ER that I would be going to (5 weeks ago!) and told her when I would be there.  That ER has a couple sections and is bigger than my ER.  The sections are the "typical ER" and then the "Critical Side" - aka the Crit.  The Crit consists of 4 critical care rooms and 2 trauma rooms.  E would be working.  Better yet, I spoke to her a couple weeks ago and she recommended that I talk to another friend of mine from that ER and tell her when I would be there.  This particular friend, "B," is what we call a S**T magnet ... especially when she is on the Crit side.  As a rule, she stays away from the Crit because all hell usually breaks loose.  Today was no exception, but I'll get to that.  She requested the Crit side when I spoke to her that day, for today's assignment, and agreed to take me on.  (Note:  Nursing students on outrotations don't usually get to pick who they're with or what role they get ... this is the first time that I've used my contacts to my advantage).

I was all excited last night, made sure that I had everything ready to go (School scrubs, stethoscope, pen, watch ... and trauma shears).  I wouldn't normally add trauma shears to my pocket, but this is B I'm talking about.  Anything could happen and that's what I was counting on (that, and the fact that "you can't fix stupid" when it comes to the general public).  I've seen so many things as an ER worker, I could go on for DAYS.  But back to today ....

Woke up before my alarm this morning.  My hair cooperated, breakfast eaten in a leisurely fashion, coffee in hand, and drove to the hospital.  As I got closer to the hospital, the song "Stayin' Alive" by the Bee Gees came on the satellite radio.  I nearly spit out my coffee.  It is a known fact that they recommend this song for CPR compressions, and encourage people doing chest compressions to sing it in their head or aloud if that helps.  Other songs, such as "Another One Bites the Dust" also works, but we try to stay positive.  When I got to the hospital, I posted, "To my medical friends: not sure if it's a good or bad omen that "Stayin' Alive" came on the radio as I drove in town this morning ..."  I got multiple responses, including "Great day for a Code" and "Oh Dear God" (the latter response from E). 

I presented to the ER early and the staff looked at me like I was nuts.  "Oh, I'm just waiting for B or E," and stood at the nurse's station waiting for change of shift.  I'm familiar with that ER, at least the lay of the land, but not all the night staff know me.  B came flying across the ER from the locker room towards the Crit side, I fell in step and we flew into CC3, where crap had been going down for a while (I just wasn't allowed in till B got there).  Now, I can't go into what happened, but a lot did.  A LOT of learning happened, too ... and I'm excited about that!  I also learned a new phrase about a Crit drip drug known as Levophed - "Levophed, better off dead."  As in, if they need Levophed, they're pretty close to death.  It does work in reversing that issue, but only if done properly and quickly.

After that patient was doing better and admitted to the hospital, we got some downtime to restock and catch up prior to the next patients.  I also was able to get familiar with where supplies were to be able to grab when necessary.  Of the next two patients, one was not so bad, the other was another Levophed case.  B was amazing, though, and even though she's a Magnet, she is one of the best nurses to take care of those cases.  She has years of ICU experience that help her perform tasks smoothly and competently.  The doctors take her recommendations and judgement very seriously.  ER and ICU nurses don't typically get along, but the skills learned in an ICU can greatly affect competency under pressure in the ER. 

Then, my day got even better ....

Today was mid-semester evaluation day.  I'm not sure how other schools do this task (if at all), but we have an evaluation paper with 12 sections on it about different things we should be doing (Technology in Health Care, Diversity in Health Care, etc).  We have to write how we think we're meeting the objectives and/or how we can improve by the end of the semester.  I'm critical of myself, but tried to be positive and also give some areas of needed improvement.  Apparently, my instructor agreed with me about my remarks and gave me a significant progress "grade" (it doesn't really count until the real number at the end of the semester).  Plus, she went on to ... THANK ME ... oh my gosh!  I wanted to look around like, "Who, me?"

This is an instructor whom I've had for multiple semesters who does. not. like. me. PERIOD.

She has never had a kind word to say, and usually criticizes me for my experience and how I'll have such a hard time being a nurse because of it.  [Yeah, I know that is a real positive environment in a school, but that's a subject for a whole OTHER post.]  So, this "thank you" really caught me off guard.  I'm not a perfect student by any means, and sometimes find myself doing the minimum just to survive a class, but ...

"If everyone came to clinical half as prepared as you, our days would go a lot smoother."

Really?  Know what I do to prepare?  Sleep, put on uniform scrubs, grab my stethoscope, pen, watch, coffee, and drive to the hospital.  That's it.  If it's a med I don't know, that's why all med rooms have books and the electronic MAR has a "reference" option.  I'm not telling her that, but I wonder what my cohorts aren't doing?  They seem to be working while we're there, and if I ask if they need anything - they don't.

She went on to say that she was thankful that I'm able to work more independently than others, and also thankful for all the extra tasks that she's been able to give me with other patients that students are having a difficult time with, when she's not able to help them (there are 7 of us and 1 of her).  I just thought that was part of teamwork ... you're welcome?

I do not know what came over her, but honestly thought I'd see pigs fly before she ever said something nice about me - to my face, no less.  Haven't seen any UFOs recently ...

Tomorrow is 6 hours of torture, i.e. two 3-hour lectures.  It is my least favorite day of the week.  Thursday will be one more trip to the Psych Ward before Spring Break.  I have my evaluation done for that class, too.  I'm hoping my instructor agrees with my self-assessment, but I'm not holding my breath for any "Thank You's."

Sick Day

Not that I wish anyone illness, but it was rather nice of my Professor to cancel lecture today due to his sickness.  I do actually enjoy that lecture, but I have a Med-Surg exam on Wednesday and housework that will definitely benefit from me not having a 5-hour absence to go to campus today.

This week has been a busy one, with a roller coaster of news.  I worked nights last weekend and will not be working any more until Spring - if I do it will be because of a last minute call out.  The money is good, but the adjustment to my sleepy clock definitely takes a hit every time.

My husband was in the process of changing work schedules from a Wednesday start of the week to a Friday.  So he got a few extra days off ... and went ice fishing ... with the guys.  He got last minute prep stuff done while I slept on Sunday, we had an excellent dinner, and then went to bed.  Yep, I was up at 230 am since I'd slept so well on Sunday.  I finally just got out of bed - hoping to be quiet - but of course that woke him up.  I worked on some school work while he was anxiously awaiting the arrival of one of his fishing buddies so they could leave.  I had to take our daughter to her orthodontist appointment at the main office (rather than their more local visits once monthly) due to conflict in schedule.  My mom was going to meet me there to run her to school while I went to school myself.  Good news - her teeth are doing great.  Bad news - next phase of braces cost $3000 with $500 due April 2nd then $175 monthly for 14 months.  We just paid off a whole bunch of things and were looking forward to saving more money for a graduation vacation in January 2013 ... ugh.  The guys successfully made it to camp and I got my agreed upon message, "Off the ice, love you babe."  What happens at camp stays at camp, but I just wanted to make sure that my husband didn't become an ice cube from falling through.  He asked me, "What did women do in the old days before cell phones and txt messages?"  I told him that we sat home and worried ... and I had enough to worry about with school, so that was the least that he could do.  I had only asked for "Off the ice" ... he added the endearing tidbit on his own ... Awe <3.

Tuesday was a day of its' own, wow.  I went to clinical as scheduled, but what my instructor wrote for an assignment versus what she said was completely different.  I started my shift, and right before I starting documenting, an RN asked me if the assignment had changed.  Luckily, she caught that ... so I ended up assessing 3 patients, before I could actually get to morning medications.  That flustered me, but I got it under control.  It was just the time wasted could have definitely been used going over the bucket list of meds that one patient had.  But, it all worked out, finally.  Plus, my very bestest friend was on the ambulance that picked up my patient for discharge so I got a hug.  And, I was able to do what she complains that nurses do constantly, call her an Ambulance Driver.  She looked at me like a) "You're lucky I love you," and b) "Just for that, you will be running your butt off on your next shift, I curse you here and now."  I told the patient and his wife that the crew they had that day were definitely more than ambulance drivers, but I get to tease them since I work with them on a rig.  The wife thought we made a great trio and it eased a bit of her anxiety.  See, laughter is therapeutic.  
Background:  We've known each other since we were in grade school.  She has worked on an ambulance since she graduated high school, either through her town volunteer service or now her full time position on a service.  She does A LOT of transfers ALLLLL day long since she's designated a "transfer truck."  Nurses will constantly walk into their patient's room and say, "Your Ambulance Drivers are HEERRREE.  Now you get to go [insert place here]."  When I entered the ER almost 4 years ago, I became interested in the field work by EMS.  I did some ride-alongs and became addicted - to the point that I got licensed.  I now work with her on that volunteer service while I complete nursing school.  I plan to progress to Paramedic level eventually.  EMS is a family ... we have a loathing of being called Ambulance Drivers, that's only part of our job.  
That night, I got the "Off the Ice" txt, which was reassuring.  What I also got was surprising ... we don't drink often, and since we've been together for 8 years, he's never gone out drinking with just the guys.   Well, apparently my husband is a drunk txter.  LMAO, that definitely started my Wednesday out well since I was down for the count when he was sending them at 130 am.  Wow, I love my husband.  :)

Wednesday brought 3 hours of story time, I truly despise that lecture.  It's not "This is what you need to know to save a life," it's "This one time at clinical rotation, I had this student that [did something horribly wrong and we were lucky to catch it.]  They did go on to be a wonderful, competent nurse."  Yes, people learn from their mistakes, but wow.  I'm starting to wonder about the competency of her instructing if her students were so bad.
My husband also returned from ice fishing camp that day and I brought home pizza since we both weren't in the mood to cook.

Thursday brought Psych Clinical.  I'm definitely getting more comfortable with the routine of the facility and going to the rec room has been very beneficial.  Not only am I getting work with my break and pool shots, I'm also entering into the realm of therapeutic conversation during FUN.  The clients do not even know that us students are getting the low down during our games, they are just socializing and having fun.  Some students (and the instructor!!) even went so far as to sing Karaoke.  I wish I'd had some popcorn.  It was hilarious.  We took some guidance from one of the OT guys and are planning a group activity for one of our sessions.  It explores the 5 senses and the bonus is you get to eat the final product (COOKIES!). 

Friday, I had a hair appointment (YAY, ME TIME!), but my husband called and asked me if I wanted to ride with him to one of his destinations.  I absolutely love to spend time with my husband, but wow wasn't my hair getting shaggy.  So I was able to reschedule my appointment for earlier and still get to go with him.  YAY!  Best of both worlds.

I worked the whole weekend at the ER, just days this time.  I honestly think the city decided to "puke" on us ... as in, everyone in the greater city vicinity either came to our ER or the other one that is 1.4 miles away (driving distance).  Whether is was via rig or POV (personal car), they sought treatment.  Living the life of an ER worker ... and I love it (even if I didn't love it at the time).

I finally got caught up on my sleep this morning, only to find out that class was cancelled.  Awesome, now I'm rested and can get my To Do List done.  Well, if I ever finish this post. 

Not Just An Ambulance Driver

I have no idea where my friend got this from, but I copied it from his fb.  Remember when you see those flashing lights and hear those sirens, someone's grandpa/grammie/wife/husband/son/daughter life is at stake.
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Standing in chest deep water, freezing rain falling and stinging as it hits the
exposed parts of my body.  Holding her head above water to keep her from drowning until rescue could get there to cut her free---
BUT I'M JUST AN AMBULANCE DRIVER

Comforting a 89 year old woman who just watch me and my partner cover the face of her husband of 64 years as he lay dead in their bathroom floor---
BUT I'M JUST AN AMBULANCE DRIVER

On scene at an MVA with mom trapped upside down in her car and her dead sons body laying on top of her, without a second thought for my own safety I crawl into the wreckage to take C-spine control and calm the frantic lady---
BUT I'M JUST AN AMBULANCE DRIVER

Called away from my just prepared meal to respond to the middle of nowhere to a house with No numbers, No porch light on, Nobody waiting to signal us in and they bitch because we took too long only to find out the patient left POV 10 minutes ago...so we smile and walk away from the verbal lashing only because we are
JUST AMBULANCE DRIVERS

Standing in the middle of the street at midnight on the wrong side of town trying to patch the holes and stop the bleeding of a 19 year old shooting victim with the occasional bullet whizzing past our heads we never break stride because this kid's life is in our hands---
BUT I'M JUST AN AMBULANCE DRIVER

Doing chest compressions on a 16 year old girl who decided this life was more than she could take. Her family screaming at us to help as though we are the ones who did this to her. Her lifeless body flailing about as the tube goes in and IV's being started, My arms and back burning from the pain of 30 minutes of CPR, never once giving up, hoping she would make it through and over come whatever lead her to this bad decision----
BUT I'M JUST AN AMBULANCE DRIVER

Death is all a round me and still I go home to live my life

I get kicked, hit, spit on, bled on, puked on...

I look into the eyes of a lifeless child at 7 am and by 8 am I'm holding my child a little tighter and they know nothing about what happened.

I have hundreds of hours of classroom time

Years of in the field experience

I have challenged death and won

I've helped the helpless

I've neglected my family for yours

I find comfort in complete chaos

I eat cold meals if I eat at all

I work with no sleep for days at a time

I miss birthdays, holidays, and school functions

I put myself in harms way for a total stranger on a daily basis

ALL BECAUSE I AM JUST AN AMBULANCE DRIVER

I AM AN AMBULANCE DRIVER!!!  I drive 90 MPH through congested traffic full of people who refuse to yield right of way while my partner stands unrestrained in the back of this screaming land missile saving your loved ones life!  Never once does he question my driving, he knows that at the end of this shift, he will go home to him family safely because I AM AN AMBULANCE DRIVER.

If you know anyone who works or volunteers in EMS - Please Thank Them. And remember, no matter what they will always be there for you in your time of need.

My Head Hurts

Tonight, I think that the hamsters have given up fighting over the wheel and are either a) fighting each other; or, b) attempting to fight their way out of my head.  Oh. My. Gosh.  I wish I were as artistically inclined as JSchro so I could illustrate that. 

Plus, I'm working the night shift again this week and I walked into complete and utter chaos.  Typically there is a systematic, controlled chaos ... nope, not tonight.  Aaaaannnnnnddddd, oh wait ... it's psych night - as in the majority of patients that have come to us tonight have mental health concerns.  If you have any doubts about the phases of the full moon and how it affects a person's mental status, work in an ER.  Worst part is, the true full moon isn't until the 7th, so tonight is almost like a preview as to what is truly to come.  An appetizer, if you will.  Thankfully, I won't be working more than tonight and Saturday night.

I also have a 7-page study guide for an exam on Wednesday and a draft of a clinical patient care plan to write that's due for Tuesday.  Ugh, just thinking about those makes my head throb.  

On top of this all ... my not-yet-12-year-old daughter has been overcome by hormones.  I'm at a loss as to how to deal with this.  Even with all my nurse training, I am just dumbfounded as to what I can do to guide her but not lock her up in her room until she's 18.  That has been a major temptation, I hafta admit.  My nurse friends who have successfully raised teenage daughters (into their 20's now) tell me, "This too shall pass."  Yeah, I'm sure it does ... but what can I do in the meantime besides the aforementioned locked room?  They laugh ... thanks ... my head hurts.