TheTravelNurse.com

The new year

2010-01-08T11:23:00.003-07:00

Ok, I slacked off on my blog...Facebook has taken over. Sorry. This new year has already brought some laughs...a 90 year old woman with a gi bleed. The doctor says I need to drop an ng..so I'm trying to explain this to the patient who is of course hard of hearing and I say" I need to put a tube in your nose to go down to your stomach and see if there is any blood in there". She says... "oh, up my nose with a rubber hose, I get it". I never laughed so much, all this from a poor little lady who I thought might not make it. She did tolerate the procedure very well, and even thanked me.
Most of my new year at work was spent in the telemetry monitor room where we watch all the telemetry for the 3 tele units in the hospital. It gives you another perspective on that position. It's not easy to watch all the screens and see if something is different from earlier in the day. It's a different kind of stress.
Here's hoping that healthcare gets better in 2010.

New nurses and nurses to be

2009-07-12T12:28:00.003-07:00

Just a few thoughts...for all of you nursing students and new nurses. Please use the time at clinicals to learn and do new stuff, not look in your books and hide in our breakroom. You only get so much time to learn, pretty soon you will be expected to do it. Please treat your patients like they were a beloved family member, or just how you would want to be treated. Spend your down time talking with them, walking with them and getting to know them, it will help you to better care for them.
Please stop whining about how much you have to read, how hard your papers are and how long it takes to get your test scores, it's meant to be stressful, because nursing is stressful. Be grateful you can see your test scores online in a matter of hours, we had to wait until the next class (up to a week,OMG)
I would like to remind you that you are lucky. There was a time when the NCLEX was only offered twice a year in major cities across the country. It was an eight hour a day 2 day test.It was a paper and pencil multiple answer exam. You waited up to 3 months for the results. During those waiting periods you could work as a graduate nurse, similar to an externship until you got your results.
It's more than a job, it's a calling.
Non noc nocere.

this weekend

2009-06-09T11:23:00.002-07:00

Ya gotta love the full moon. It brings out the interesting people. And the beloved change of shift code....classic Torsades de pointe. The worst part was that he was a relatively young man and his Mom was in the room when he went out. We tried to get her out but, the code cart was blocking the doorway out of the room, not to mention the numerous bodies that filled the room. I think she got to see the first shock...pretty traumatic, but, it was life or death at the time.We got her out to the desk and spiritual care was there to be with her.He was intubated and sent to the ICU and returned to our unit later the next day. Lucky.It just seems I am seeing younger and younger MI and coronary artery disease patients.38 and 40 year olds having triple bypass and more. Most of them preventable with the right lifestyle changes...you can't change what's inherited but you can keep from adding to it.It's a choice. Life is a choice. Your life is your choice.
Non noc nocere

Cardiac stuff

2009-06-02T20:45:00.002-07:00

I had a great weekend, went to a cardiac symposium put on by one of the local cardiology groups. It was held at the Arizona Golf Resort..very nice and great food. The speakers were informative and some of them were even funny. No, really, Cardiologists, funny, I swear. The latest stuff...lets see..not 3 nitros for chest pain, if you take one nitro wait 5 minutes if it doesn't help call 911. The newest dose of aspirin is 162mg, 325 after a stent for a month or so then down to 81 or 162 the whole time. Percutaneous valve replacements are being done at certain sites across the country right now but they are a thing of the future. To see all the info...www.tricitycardiology.com.
I had a 75 ya\ear old woman who went into rapid a fib even though she was on a maintinence dose of Cardizem. Her b/p was 100's over 60's...doc ordered 600mg of Rythmol then 150mg bid plus and increase to 240mg Cardizem. I was nervous, he said it would be fine...I warned my coworkers to keep an eye on her heart rate for me. I gave the Cardizem then about an hour later I gave the Rythmol. About an hour later she called and said she felt dizzy, I had the nursing assistant take her b/p but I went in the room as well...good thing, her b/p was 59/30... and she was on her way out. I called for the charge nurse, some saline and oxygen but I stayed with her, then I called the code. She was out not responding, couldn't get a b/p, eyes rolled back. I put the head of her bed down and was doing the "Annie Annie are you ok" thing when she opened her eyes, I was relieved ,somewhat ,but not out of the woods yet. Luckily the doc was still in the hospital and came when the code was called...we gave her fluids, some atropine, cuz her heart rate was 30, then she started to throw up...gave her some Zofran...and another bolus of fluids. The code team left and I was there with her and the doc. I stayed with her and explained a little bit of what happened, I called her family and at her request, asked them to come to the hospital. Her daughter ended up staying the night with her. She made it thru the crisis and went for a cardioversion the next day. To my surprise, when I asked the monitor room, they said she never did lose her heart rhythm, just her blood pressure.
Moral of the story...listen to your gut instinct. I didn't want to give the meds... I just had a feeling. The doc explained that the Cardizem would slow the rate and the Rhythmol would make her heart beat faster and that would hopefully convert her rhythm..it sounded good but I was still uncomfortable, which is why I enlisted my coworkers help to watch the monitor. Ah, the joys of cardiac nursing.
Non Noc Nocere

On the road nursing

2009-05-18T09:45:00.004-07:00

So, I got a text message last week that my sister was on vacation and had chest pain. She was sitting in a hospital in Las Vegas and her kids were in Oklahoma City freaking out. I took the short 1hr flight to be by her side and translate the medical system for her and her husband. She is not the easiest person in the world to please, she has very high standards. Since she had gone by cab to the hospital, she ended up at a low standard small facility just off the strip. (no name, at this time) I had never heard of it before, nor had anyone I know heard of it.
The hospital was small, maybe 5 floors, and not modern in anyway. Unfortunately it was not kept very clean either, much to my sisters horror, she thought hospitals were clean places. Funny how most people think that. She had her ekg and her serial cardiac enzymes which were all negative and she was pain free. She was in the middle of her stress test when I arrived. I walked back up to her room with her. The transporter said he would let the nurse know that she was back,my sister had not yet met her nurse. The "nurse" didn't come in to say hello for an hour and a half. And that's all she did was say hello, no stethoscope, no vital signs, nothing about whether she could eat or drink...just, hi I'm your nurse I'll be back with your pills. About 2 hours later she was back with her pills, no beta blocker though, just aspirin and nitro, and of course Protonix.(wish I had bought stock in that drug company). That was it, didn't see her again. Twice in a twelve hour shift, really...are you kidding me? That is acceptible nursing care?
Then we met the doctor with a chip on his little shoulder. Did not want to hear about letting my sister leave and go back to Oklahoma...granted her stress test was positive for reversible ischemia, but, she's pain free and there's no positive enzymes. He ordered a cardiology consult...ok here's my irritation...it is now 6:30 at night on a Friday in Las Vegas...could we not have called doctor attitude when we got the results and told him so he could ask for a cardiology consult earlier? Frustrating. Not to mention that my sister was not offered so much as a washcloth or a towel (not even one left in the room) let alone to be set up to bathe or change her linens. Plus the fact that one of her telemetry leads was off for over an hour, yeah I put it back on after I helped her get a bath...yeah, no one came in when they were all off either. Thank goodness the night shift charge nurse and nurse were excellent. They came in and introduced themselves and did an assessment and told her about her meds and everything a good nurse should do.(thanks Cheryl and Joy)
We saw the cardiologist by 11am on Saturday, he talked about a cath until we told him she was there on vacation, was pain free and wanted to go home to follow up with her cardiologist there. He said fine, as long as she flew home and didn't drive back...Dr attitude said no, he would not sign her discharge, she has to sign out AMA. What a power play. So, we eloped instead...lots of people don't know it but, you can just walk out without signing the paper.
It was a long ride home with an emotional sister, she hates flying, but we made it safely. She had her echo and her cath and no MI or blockage thank goodness. Probably the rare cardiovascular artery spasms...leave it to my sister to be one in a million.
I came away from the experience with a new view and appreciation for my patients and their families and what they have to go through with our messed up medical system. Minutes literally are hours when you are waiting. Keeping people as informed as possible will keep them happy...most people anyway.
Send me an email before you decide to travel to Las Vegas and I'll tell you the name of the hospital to avoid.
Non noc nocere

Nurses Week

2009-05-16T19:48:00.002-07:00

Talk about cutting back.... how was your nurses week? Mine was anticlimactic to say the least. On Nurses day we got these info cards on bright green card stock... the info was how we could do better. Things like answer the phone (within 3 rings) with a smile on your face as if you were on video. Before you leave any patient room or visitor encounter ask if there is anything else I can do for you. And if , I'm sorry when (within 1 minute)you answer a call light own it and play it through...yeah it was that kind of Nurses day. Not a thank you or a nice job or any of the positive things we should hear..just work harder. No lame lunch bag, no water bottle, not even so much as a free pen...how about ya'll?
non noc nocere

Depends on the day

2009-04-21T13:19:00.004-07:00

The first picture was from our second day at the Grand Canyon...thank goodness we had the first day (second picture) otherwise we wouldn't have seen any of it's beauty. Sounds like work...some days you see the good things you do, others there's just so much in the way you can't see at all. Hope you are having a good day.

More good news

2009-03-04T14:21:00.003-07:00

Well,this proves the determination of my husband. He looked at this hole, and the ones in each of the other 2 bedrooms, figured out the tools he needed to fix them, and just did it. I really wonder how our renter made this hole in the hard wood flooring? Any ideas? There were boxes for air mattresses left in the house amongst all the rubble, so, it wasn't a bed, what else could it have been? It is still very disheartening to me. Is it really true that people just don't care any more? The have no pride in ownership or being self-sufficient anymore? That is really sad.

Work is ,unfortunately, just as depressing. I really dislike working in the downtown inner city hospital. People are different than they are in suburbia. They demand things instead of ask for them, they act as though they are entitled to demand them...like some how I owe them something. I am not saying everyone, but a larger majority than I see out in the suburbs. I took care of a guy who refused to leave the hospital, he was discharged and refused to leave...he stayed there an extra 3 days...at whose expense? ...he refused to call medicaid to appeal his discharge, he just refused to leave, he had demands before he left...everyday they were the same, he wanted to see each one of his doctors, though he had seen them or one of their partners the day before. He wanted his dialysis time changed, he wanted new medications, he wanted a different diet. But, he knows his patient rights....whatever dude. Why can't we demand he take care of himself, eat right and exercise, not do drugs or drink alcohol, take his medication and follow up with his doctors like he's supposed to? We ask him to ,but we still take care of him when he doesn't, we still allow him to come in to the hospital and get care even though he can't pay the bill. What has happened to taking care of yourself? Guess we've shown that you don't have to do that either, America will take care of you. And you don't have to be nice or ask politely or anything, we just have to do it...patient satisfaction you know.

Ok, I'm off my soap box...on a good note I might be able to make the move back to the hospital that is closer to me...they have a job available. I just have to convince my new boss that she should let me leave. That one's gonna take some thinking....

My orientee is close to being out on her own, I think she needs a little more time...they only get to be with us 2 days a week, the other day they spend in class. I thought they just got done with all that learning stuff...guess not. I will ask for another week for her but I'm sure the budget will rule the answer.

Until next time...non noc nocere.

When life gives you lemons

2009-02-19T10:10:00.003-07:00

This is my fixer upper in Columbus, Ohio. My husband and my brother, with a little help from me and my nephew, turned this 1930's 3 bedroom 2 bath into a nice home. Granted it's not in the best neighborhood, but, it's not in the worst either. November of 2007 we finished it and put it up for sale, the market sucked of course, but we got a renter/buyer March of 2008. We thought we were helping out a single Mom who was moving to a new city, couldn't afford to buy a home yet but we gave her the opportunity to rent our house and build up her credit enough to buy it and become a home owner. I guess it was a fairytale for both of us. She has not paid rent in 4 months. We were nice enough to give her 30 days to move (Ohio has a 3 day eviction process) again shooting ourselves in the foot. The house is full of trash, they changed all the locks, holes in the hard wood floors, completely turned off the heat so the pipes could freeze in the 30 degree weather, and took the alarm remote. I am so disheartened. Please someone explain the rationale. Why would you trash something nice someone is trying to help you own? I watch Extreme Makeover Home Edition and see people who fall on tough times get help and they are so grateful...do they end up trashing their home as well? I'm very disheartened...but that doesn't mean I quit. I know what I did, by trying to help this person out, was the right thing to do. I know it can work. I still believe that real estate is the way to go..it's something tangible, something real, not worth as much as it was a few years ago but, still worth money. It is just a game of numbers. Thomas Edison tried over 10,000 times until he finally got the light bulb to work...where would we be if he had stopped trying? In the dark, like my poor husband because the renters broke ,stole or unscrewed all the light bulbs in the house...lol. Ya gotta laugh..pick yourself up, dust yourself off and try again.
Work has been steady...4 or 5 days a week. Anything I can do to help pay 2 mortgages. I thought about a job in education. Monday - Friday 8-4:30 no weekends no holidays, a nurse's dream...but, also not a sure thing. Budget cuts are looming in the shadows and I see educators on the top of the list. I have an orientee with me...she is a really bright girl, very sweet and kind. I think she is there, at that big downtown hospital, for the experience. I think she would fair much better up in Scottsdale once she gets her experience. But, again, jobs are pretty scarce these days, you don't get the luxury of coming in and naming your price and hours and which days you'll work. You are glad to have a job that pays your bills.
Well, wish me luck and, if you can, please help me to understand people. Non noc nocere.

Coming home

2009-02-03T19:07:00.002-07:00

As most of my readers know my nephew is in Iraq right now, and has been since early last year...I am happy to say he will be joining us back here stateside within the next 2 months. I am happy and relieved that he has been safe and admire his dedication and all the sacrifices he has made for our country. Wonder what he thinks of is new boss?
The cardiac cath I went to Oklahoma for went well, no complications. The new diagnosis and changes in lifestyle were a little difficult to get across at first but, I think they will do just fine. The number of Americans with coronary artery disease is rising everyday. I take care of these people everyday, and everyone says the same thing. I don't eat that bad and I just need to exercise more. Ok, there are other risk factors, some you can control, some you can't. Yes, you will most likely have to take medication for the rest of your life...many studies have been done to prove the efficacy of this routine. But, you are ultimately right, diet changes (low fat, low cholesterol, low sodium) and the addition of exercise will only have a positive impact on your life. Sorry, guess I'm just tired of taking care of people who drink excessively, and smoke and don't exercise. I don't like exercise either, but...I know what will happen if I don't.
Work has been ok. The day of the Superbowl was less quiet than I thought. I figured I would get all my work done before it started and people would just watch the game..no really so, they still wanted their beverages and ice and pain meds. The downtown hospital was actually a little slow, they closed one pod (15 beds), guess nobody felt sick that weekend. The worst part were all the people wanting to go home to watch the superbowl. I actually had a patient who was in with severe vertigo, like she couldn't even walk to the bathroom without help and she bugged me all morning about going home for the superbowl. The doctor came in and tried to walk her and said no way...it ended up she couldn't even watch the superbowl on the tv because she was so dizzy it was making her sick. People.
The weather is getting warmer...78 degrees today...and sunny. Sorry all you Northeasterners...non noc nocere.

Barrett-Jackson or Cardinals?

2009-01-17T09:15:00.003-07:00

This is a car made for Pope John Paul II but he never rode in it, it was deemed unsafe for him. You'll only see stuff like this at a museum or Barrett Jackson.

If you know me , you know my answer. I love Barrett-Jackson and all the fantastic cars. I watched it on television for years, God bless the Speed channel, and finally 2 years ago I was here during the blessed event. If anyone says there's no money being spent in America all they have to do is turn on the speed channel, $200,000 for one car...and it's not even Saturday. These cars are amazing, the restorations are superb. Just the sound of the engines sends chills up my spine. I thank my brother for introducing me to muscle cars and helping me learn to appreciate a great sounding engine, and my husband for keeping the thrill alive. He has patiently taken me to the auction for the last 3 years, and answered all my questions with out making me feel stupid.

As for the Cardinals, I am not a fan. Only a fan of whoever beats the Steelers...I am a true blooded die-hard Browns fan...sad as it is, year after year I keep hoping. Most people think it will be the Cardinals vs. the Steelers for the Superbowl...guess we will find out tomorrow.

Work is crazy as usual, I now have a tail for the next 12 weeks. I hope I can help to mold her into a useful, well adjusted, thinking nurse. (Without making her quit or driving her crazy first.) Non Noc Nocere

Close to home

2009-01-11T10:05:00.002-07:00

Like the title says, I have some family issues, and they are hitting close to home. One of my family members is headed to the cath lab for a cardiac cath. Now I can really put myself on that side of the bed. I am used to being the one coming in and reviewing what the doctor told them, answering any questions and sending them off to the cath lab. I am also used to getting people back from the cath lab and doing the normal stuff, checking their vitals, checking their pulses, checking their groin site...I guess I will see what it feels like to not be in control of anything. Nurses really are, or become control freaks, I think. Ok.Maybe it's just me, but if I am in control of a situation I can 99% control the outcome. That makes me calm and confident...and a control freak. If I am not in control (i.e. things don't go the way I planned them) then I'm irritable and I snap at everyone around me. Yeah, I got issues. I just hope I can be a calming force when I am with my family member during this procedure, because I won't be in control of anything.
On a lighter, happier note my nephew should be headed back from Iraq early this spring and I am so happy about that! I hope he gets the chance to stay stateside for a long time!

HAPPY NEW YEAR!!

2009-01-01T10:32:00.003-07:00

Well, Happy 2009 everyone! We brought in the new year in the same old fashion, watching Dick Clark and Times Square. Pretty sad to see him get old though. He looks and speaks pretty darn well for a stroke victim.
So, I worked 5 days (12 hour days) last week and had one day off and worked 3 days already this week. The company I am working for is doing away with their double time for overtime so, I had to get as many hours in there as I could. Smart business move, they have filled most of their nursing positions with the new grads and they are all willing to pick up overtime since they are fresh out of school and money from being in school.No one is really happy about losing the double ovetime but, we can understand. Of course there are the people who just live to complain, I try to stay as far away from them as possible. Some people would complain if you gave them the world.Sad.
What can I say about work this last week. Wasn't too bad, but the new nurses, I think they are so overwhelmed. They don't seem to even know which questions to ask or when. Our unit is post open heart/thoracic surgery. The daily tasks for each patient is a huge laundry list. You have to monitor their weight, vitals, electrolytes,their exercise, their fluid balance, their rhythm,their blood sugars,plus all their tubes and lines. It's really difficult when you have more than one cabg patient.I started out in Medsurg, back then units weren't so specialized, it was med surg or step down or icu. I think it really helped me get my organizational skills together.75% of nursing is organizing your work, the other 25% is common sense.
Case in point: I had a new nurse ask me at about 8:30 in the morning if I thought she should change an IV on a patient that was 7 days old, this was a post open heart patient. I said definitely. I heard her later ask another nurse the same question she agreed with me and said yes as well. At 5:30 pm she again asked me if I thought the iv really needed to be changed, I said I really do, do you want me to change it. She said no, I want to try, but he had a really bad experience and doesn't want it done. I explained to her she has to be comfortable and make him comfortable, if she wanted, she could have someone else do it. She ended up asking the charge nurse to do it, and it got done at 6:30. I just don't get it. The longer that IV stays in the bigger the risk of infection, we have to be able to tell patients what we know is best for them and just get it done, not sit around and wait all day to build up the anxiety of the nurse or the patient. But, how do you teach that?
Can you guess what my picture is of?
Non noc nocere.

Merry Christmas

2008-12-27T11:33:00.002-07:00

Yeah,yeah,yeah so, the title isn't very politically correct...cuz, it's my blog, that's why. Sorry, had to say it. So, how was every one's Christmas? Was the Christmas spirit alive and well in your world? Maybe it was if you weren't working. Boy, people are just plain crabby sometimes. So, you can complain about having to take Mom home on Christmas day and have to look for an open pharmacy or you can be happy that you get to take Mom home on Christmas. Maybe people don't realize they have a choice. So, that was my Christmas, most people were happy to be alive and realized they might not have made it to Christmas if they hadn't had their open heart surgery. But, there were the few who just complained anyway...what can you do?
I am working with a gaggle of brand new nurses. Some have only been off of orientation for a month...it's kinda scary. They seem reluctant to ask pertinent questions, or any questions. I had a nurse talk about having to re start an iv for about 6 hours of our 12 hour shift...I finally asked her if she wanted me to do it. She said no, I want to try, but he has so much hair on his arms. She seemed in awe when I told her she could shave his arm...she finally got the iv but, procrastinated about it all shift.I think she might be a little too nervous to be on PCU, med surg might be better for her. It's still busy but, her patients wouldn't be of such high acuity. Guess we'll just pray and keep our fingers crossed. I'm there to help and guide as much as I can, please remember to ask if you have a question...it could save someone's life not to mention your career.
I heard people complaining about some of the cost saving measures that the company I work for is making. Why are people always complaining? This company had a difficult time filling it's empty shifts a couple of years ago and started paying it's RN's and LPN's double time for overtime, they have decided that this is no longer a cost effective measure, yeah it's sad to see it go, but, now they are just paying us like every other nurse in Arizona. Times are tough all over, it's your attitude that will make or break ya.
Non noc nocere.

Downtown

2008-12-14T10:18:00.003-07:00

Well, I had forgotten just how sick some of the folks can be when they come into the hospital. Especially the big level 1 trauma centers, they get it all. Here in Phoenix there are a few, 3 I think, level 1 trauma centers. Since the population of Arizona is largely in 2 main cities (Phoenix and Tucson) and then there are lots of little communities throughout the state, when someone is really sick they send them to Phoenix. This is my first week in my new position, I have had one patient with a chest tube, pca and epidural both of which were set up as pca's...yes, she could control the bupivicaine in her epidural, which was in for the sole purpose of controlling the pain at her chest tube site. Never seen that before. I also had a patient with 2 chest tubes, one was attached to a little accordian looking collection bag (never seen that before) an ng tube, a g tube, a foley and a picc line. The ng was to wall suction plus he was using a yankaur suction for his saliva so, we had to get the old fashioned portable suction. Yeah, more tubes than I have seen in a year, I got them all in a week. They call that initiation by fire. The nurses I worked with, although inexperienced, were very helpful and friendly.
I am getting used to the drive, still not liking it, but, getting used to it. Wish me luck. Non noc nocere.

New position

2008-12-07T11:13:00.004-07:00

Ahh, Christmas in Arizona. Ya gotta love the decorated palm trees and cactus. Oh, and the weather it's getting a little cooler 40 at night but still up well into the 70's during the day.
I had my 2 days of orientation fro the hospital this past week and I actually learned some things. I had 2 days of orientation on the floor this weekend and next week I'm on my own. The unit I am now assigned to has had a huge turn over in the last few months. There are a bunch of newbies...like less than a year under their belts. It's kinda scary because these folks are some of the really sick. They need people to be on top of their game and to be able to spot a problem in the earliest stages, which can only come with experience. Things like an transvenous pacemaker, gun shot wounds and lots of chest tubes are being sent to this unit. So, wish me luck. As always Non noc nocere.

Stayin in Arizona

2008-11-29T10:14:00.002-07:00

Yeah, how bad can it be to live here year round? Well, I've been here over a year already, survived my first summer, and I still love the weather. How can you not? If it's too hot, drive an hour or so and you are in the mountains. If it's too cold or wet up there, come down to the valley. More sunshine than grey, more heat than cool, what more could you ask for. Ok, maybe a beach, but that's it.
I am a victim of the crappy economy. All the hospitals are tightening their belts, they may not need to but, it's a good excuse. I am now officially a Banner staff member. I got a pretty good rate, plus the insurance is incredibly cheaper, and PTO when they call me off like this week. I tried everything this week to work...the only day I wasn't signed up was Monday...I only worked 32 hours...that sucks. But, Monday I get to go to orientation, again. Yeah, free money, maybe I'll get some orientation on the floor or maybe they will send me to computer class again,lol.
It's been a good ride. If I wanted to work nights in Oregon or days in Rhode Island I could have gotten a travel position. But, I'm beyond all that. I've been nursing way too long to put myself in an uncomfortable position again. Not that a staff position is all that, it's just something different for a while.
Non noc nocere

What's next?

2008-11-16T09:54:00.002-07:00

Aahhh, Phoenix in the winter. Dang, you just can't beat this weather, how did I live for so many years in the frozen north? It was 73 degrees at 7:30 last night on my way home from work...amazing. And sunny everyday...the days it is gray are so rare, what a switch from Cleveland.
Well, traveling is getting a little more difficult and not paying as well. I got offered $28/hr blended in California...yuck. As a matter of fact, I cannot find a contract in the state of Arizona at all...so, I think I will be making the plunge into staff nursing. Wow, never thought I'd say that. I just really like my life the way it is right now, and I don't want it to change. I don't want to leave my husband for a job somewhere else again...so, I guess Arizona is my home for awhile. My new boss to be seems very accommodating. She has let a majority of her staff take off weeks at a time for personal reasons or for the holidays. No, I don't love everything about the job or the idea of a pay cut, but, it's better than no job. And it's better than night shift somewhere or ending up in a situation like I had a the other hospital I transferred to. I have already been here 11 months...at this hospital, and been here in Phoenix just over a year. It'll be hard to get used to getting paid every 2 weeks but having PTO will be a nice switch. Yeah, everyone is still complaining about not getting any over time but I think they are just complaining to be complaining... I see them at the hospital everytime I am there...and I'm getting my 4-5 days a week. Gotta let it go, let them keep complaining and see where it gets them, huh?
Well, say a prayer for our troops, take care of yourselves...non noc nocere.

Spoiled

2008-10-22T20:24:00.002-07:00

Yep, that's me. Everytime I have to take care of myself I realize it again, I'm so spoiled. My husband is such a great guy, he does everything...ok so, he doesn't have to go to work but, he does everything else. This week I've had to do it all myself. Take the dog out in the morning before I go to work, get ready for work, make my own coffee,drive myself to work, (park in the parking garage which I hate and walk to the hospital) drive myself home, walk the dog, feed the dog and myself..ugh it's like 2 full time jobs. When I was in Virginia at least I only had to take care of myself, ok I was lonely, but, I didn't have to get up so early. Ok, yeah I'm complaining...sorry, like I said I'm spoiled! I have been taken care of and catered to for the last 7 years that we have been on the road...I would not give it up for a second! I will continue to work and have him here to clean and do laundry and take out the trash and cook and take care of the dog...I got the easy part!
I'm sure there are others out there who are in my position, I know at least one and she loves it too...yeah nobody wants to work but, if you do have to work this is the way to do it...my normal life: I get up and shower after I start the coffee maker which is ready to go I just have to turn it on, then I get dressed, get my coffee, get driven to work and dropped off at the front door, get picked up at the front door , come home change my clothes have some food that has already been prepared for me and sit on the couch and watch tv or surf the Internet until it's time for bed. Sounds rough huh? I am very lucky to have the arrangement I have and luckily my husband feels the same way. No, not that I am so lucky , that he is so lucky maybe that's why it works for us. Here's to a loving, caring, give and take relationship!!! I wish it for all of you!
Non noc nocere.

Life...

2008-10-19T11:01:00.002-07:00

This is part of the awesome metal display by the Bricktown walkway in Oklahoma City. All these pieces are forged in Norman and brought to the site...it is supposed to tell the story of taming the west...the pieces are bigger than life, just amazing.

Well, it has been a good couple of weeks at my old home. Of course I have been able to work a few days on my old unit. I feel really comfortable there. I feel like I know what to do and who to go to which makes it easier to care for my patients. I went to a different hospital about 2 weeks ago and it was a disaster. I couldn't get the hang of the computer system, I didn't know who to call for what...it really made me feel ineffective as a nurse. There is a huge difference between being a traveler and being an agency nurse. Agency/registry nurses go to different hospitals and different units daily, plus they get almost no orientation to the hospital or the unit until they get there. You have to have a lot of confidence in your skills to do it. As a traveler, you go to the same hospital but it could be a different unit and you get at least a day or two of orientation, so you have been to the hospital before you actually start working and you have some idea where to go and what to do. Maybe I'm just getting old.

On a sadder note, my husband lost his mother this past week. She lives in Ohio and she is an old world Spanish woman. She never worked outside the home, never drove a car, and spoke very little English. She mellowed with age and actually tried harder to communicate with us in English. It was quick and unexpected, but she didn't suffer, which is the only way to go. The down side is no one gets to say their good byes. Tell the people you love everyday how much you love them and don't leave the house angry...just a little advice. non noc nocere.

Workin it out

2008-10-05T10:20:00.005-07:00

Just a couple of things you will only see in Oklahoma..ok, that's the only place I have ever seen them. The sign was above the water fountain in a Home Depot. The other picture is of the baseball field at Bricktown with a statue of Johnny Bench. We made the 14 hour trip to Oklahoma to visit with my family and see my nephew who was home on leave from Iraq. It was a nice trip...so good to see family.

I guess sometimes it does help to complain when things aren't going right. I got a call just before I left on my little vacation from my travel company..they said I could go back to the other hospital I was working at and be a tele med surg float over there...hell yeah I took it. I was doing my last 2 shifts at the new place when I saw one of my traveler buddies from the other hospital. I had forgotten that she had asked me like my first day there how it was because she was thinking about coming over there. I had told her it wasn't bad...cuz it was too early and I didn't know. But, when I did see her I let her in on what was happening, then Friday I was with her when she oriented.She somehow got stuck with someone I hadn't worked with before and she didn't have her stuff together. It was also the day they in formed their staff that due to some issues with the flooring ,they were going to close some beds and that they would be having patients in the hallway waiting for the beds of patients that were discharged. Can you believe that crap? You are expected to remove the iv and remove the tele box and give your patient their walking papers as soon as you get the order then, another patient will arrive and sit in the hallway with a little privacy screen around them until the other person leaves...or you could choose to put the discharged pt in the hall or the conference room and have them wait there until their ride comes to get them...hmmm, so much for patient satisfaction. Give me your thoughts...

Non noc nocere.

Workin in the desert

2008-09-22T11:06:00.002-07:00

Well, it's been another week ...that means 10 more to go before I get to get outta this hospital. How to survive a travel assignment you hate: grin and bear it, make the most of it, just do your job to the best of your ability. It all sounds like good advise doesn't it? Some people would just up and quit..find a different assignment in a different hospital, I've done that as well. Burning your bridges is never a good idea...hospitals can change when the staff changes or they start losing enough nurses they figure out what's wrong. Plus if you like your travel company, you don't want to piss them off either. Yeah, it's a tough spot. If you really feel like your license is in danger I say by all means call your recruiter and tell them and don't put yourself back in that situation. I have done that, when I was in San Pablo CA..it was absolutely awful..I called my recruiter and I got another assignment...never went back. This hospital, it's just irritating stuff.I will refuse to take ER patients when I get sent back to the ER...that's because it is not in my scope of practice...hopefully they will refuse to have me back. Other than that I will continue to communicate my dislike for the units and staff and the assignments I am given in a constructive manner to my agency. Not that it will get me anywhere but it will have it documented. Wish me luck.
Non noc nocere.

Calling all ER Nurses

2008-09-17T16:14:00.004-07:00

Hey there all you adrenaline junkies...my hat's off to you! I don't know how you do it but I am glad you do! My question is how do you feel about your ER being invaded by floor nurses, who are clueless as to how your area works (such as myself), when you all are running short?
I got floated to ER "holding" yesterday and it was a friggen nightmare. My first time down there, no here's where your area is and here's who you can ask for help, no here's how we do things in a nutshell...just here's your rooms. I got stuck with a Registry ER nurse who was willing to help when she could, thank God, otherwise I'd have really lost it. The gave me not their floor or PCU holds...but the BHS (behavioral health) holds...all one to ones and a PCU hold..Then they started moving patients on me and not giving me report (apparently I was just supposed to research the pt myself or go find the nurse who sent them over). But, how was I supposed to know any of that? I get a transferred pt from another room, no report, I thought it was someone else's pt since I got no report...guess it was mine..she had a blown iv an was diabetic who hadn't had a blood sugar check since breakfast and hadn't eaten...VERY NICE. Then they kept tossing the BHS pt to me...then they wanted my to take an ER patient...I said, probably for the hundredth time, I am NOT and ER nurse...but they put her in there anyway..bp 75/50...VERY VERY nice. They said "Shawn will help you" well, I never saw "Shawn", the nurse who was doing discharges took one look at this lady and got to work...she ended up being moved out of my room to somewhere else and we looked at her blood work later...let's just say I don't think she made it.
Then they put another patient in that room and the chic who handled the last one says this one is yours, I just gave her that look...it was a 23yr old who took an overdose of somebody elses meds...also not my area of expertise.
I must tell you that at about 12:30 after the incident with the no-report-patient I called staffing and said that they needed to get me outta there...they said we really can't and sent the supervisor to talk to me...I told her I was very uncomfortable and was being given ER type patients not waiting to go to the floor type patients which I was told I would get...and that I wanted to leave. She listened to me blubber for about 10 minutes and said she would try to get someone to come in early...yeah, OK...meanwhile the Registry chic that was helping me had completely disappeared and I was left with Miss Attitude ER nurse who eventually just took all my patients and I got to go home. I guess they realized what I had been telling them all day...I was just in the way.
So, as ER Nurses, how do you feel when we non-ER nurses come to your area? I understand it would be different if you had a bunch of floor holds and I was there to take care of them...I'm just glad I got out without hurting anybody. Absolutely the worst day of my nursing career so far.
First do no harm.

Is it a full moon?

2008-09-13T11:58:00.002-07:00

The fountain at the new Palazzo in Las Vegas. Everytime a new casino opens it is more elaborate and more stunning than the last....ya gotta love Vegas.

Was it a full moon yesterday? Wow, my day started out ok. I went to a different floor at the new hospital I am working at , it was the surgical floor. Not a big deal, I can do surgical. It started off kinda crappy because I couldn't punch in, there was no paper to tell me the punch code for the unit, so, I had to walk over to their sister unit and punch in there, only a minute late not too bad. Then I came back and get report, doesn't sound too awful. They came from Interventional Radiology and swept my patient away while I was in another room...didn't get to see him. Then I have the guy who's wife is a nurse (great), someone else going to surgery, somebody with back pain and a copd pt. The morning was ok, trying to find my way around the floor and learning the flow...my other guy goes to surgery, and I get to eat lunch. When I come back, my first guy comes back from IR with a stent in his leg and has to lay flat for 5 hours, my other guy comes back from surgery in pain, my pca has to be changed, my copd pt thinks she has a blood clot in her leg and calls her family who calls me then....

My back pain guy calls me and says he's in a lot of pain in his face...I went to his room and he is squirming around in the bed, his jaw is all clenched he feels like he can hardly breathe, he is majorly freaking out...and secretly so am I ...no idea what is up with this guy. He says he feels like his head is all distorted and he can't close his eyes.or open or close his mouth all the way and he really sounds like he's having trouble breathing. So, I use my calm voice and hold his hand and tell him to breathe through his nose. The cool thing about this hospital is that the hospitalists are on the floor from like 8 in the morning to like 6 at night..literally they see everyone on the unit and they have a little office they sit and chart in. So, I go and get the doc...we give him Ativan and it helps a little...the doc asks what meds he is on and one of them is IV Reglan...you can see the light bulb go on above his head he says give him Benedryl and Cogentin..IV. I have never given cogentin IV before but, it worked! The guy was having an acute dystonic reaction to the Reglan. Never seen it before in my life...I have given Reglan hundreds or maybe even thousands of times...and this guy had been getting it for at least 24hrs...weird. He was very nice and grateful for us being there and helping him so quickly. I told him he taught me something and he thanked me again for being there and being calm.

It's weird how that happens...in that emergency kind of situation...I can keep cool and not look freaked out even though inside I'm going "Oh my God, Oh my God, Oh my God...somebody help me!!!!" I don't like the feeling and that's why I don't do ICU...stuff like that happens so fast and it happens all day long...my little heart couldn't take it.

So, after all that you'd think I'd get a break or something, like in football after a really big play the wide receiver gets to sit out a down or two to catch is breath..nope I'm right back in the game. Giving my pain meds, checking pulses, giving insulin, printing out education materials...constantly moving constantly checking my patients...you'd think I'd weigh about 100Lbs with all the walking I do,huh. Fate.

Non noc nocere.

Vegas

2008-09-05T12:42:00.002-07:00

Hi all,took a few days off for my wedding vow renewal. Here we are after the ceremony in the conservatory at Bellagio. Behind us is a miniature of the Bellagio and a miniature Bellagio fountain...only in America. We did a drive up wedding, it was as expected. I would probably pick a different place next time we went to A Special Memory Wedding Chapel on a Sunday afternoon. It looked pretty deserted, we picked from the "drive up menu" but we were told some of the items they no longer offered like the commemorative photo. I was not really happy about that one...our only option for pictures was a package of 6 which would cost $70...no thanks. We did our vow renewal ($25) and had to pay the "minister" her gratuity (no less than $40) for our 5 minute ceremony. It's was an experience. I found that people are really nice to you if you are wearing a veil..they'll even take your picture and not steal your camera!!
This week I started at my new assignment, 8 miles in the opposite direction of the other hospital. I find that a new building and "healing" surroundings doesn't actually change how it operates. It's the same stuff in a prettier package. Same amount of patients going and coming and no team work. The charge nurses are still just a voice on the vocera or a piece of paper on your desk with another patient's name on it. No thought to how many patients you have already admitted or even ask if you've had a break, she was nice enough to take report for me so that I had absolutely no warning that my patient was coming and then poof she was just there in the room. Yeah, it's like that.
I do miss my friends at the other assignment.. I was hoping to go back there prn but, I don't know if that will be possible either. Computer glitches might prevent it.
Sometimes I do wonder why I continue in this field, then I get the paycheck and the reasons are a little clearer...sometimes I even get a thank you and then I know why. Non noc nocere my friends.

Summertime

2008-08-19T16:56:00.003-07:00

So, my nephew was here for a week and we went to see the D'Backs play. It was a good time. My sister was here for 3 days and we just shopped and relaxed. I wish she would have stayed longer...but, that's the sign of a good visit huh? That they leave and you wish they would stay longer, not the other way around.

Plus, I get 4 days off in a row (woohoo)then it's off to Vegas for 3 days. Work has been good, not too busy not too slow. The patients have been much of the usual. Too young to be as sick as they are,but, since they didn't take care of themselves ...they are in the hospital. Most of them smokers, who think they are ok cuz they can still talk and walk, they think they can keep smoking...never mind the fact that they couldn't breathe when they came in or that they just had a triple bypass...they are fine now and all they need is a smoke. Or the alcoholic who was back 2 hours after they were discharged so drunk that they ended up in the ICU....pretty sad.

6 more shifts then I'm off on a new venture. I have a computer class next week for the new hospital...the doctors over there have to enter all theire notes and orders into the computer...yeah! No more bad penmanship!!!!We'll see how well it works. Wish me luck!

Remember..first do no harm.

What do you thnk

2008-08-05T09:51:00.002-07:00

I just read an email from my nurses e news and I am not sure how I feel. It seems the US government has a proposed bill..HR 5924 to get rid of the cap of 20,000 work visas per fiscal year for nurses and physical therapists from other countries to come here and work. It is proposed as the Emergency Nursing Supply Relief Act. It also allows for more grant money for nursing schools which I wholly agree with. I am just on the fence with the influx of foreign trained nurses.
The floor I work on now is very culturally diverse. The problem I have is not with the nurses themselves it's with the communication barrier. We do walking rounds at our facility when we change shift. I introduce the next nurse and sometimes the patient will make a comment or try to make a joke and the nurse doesn't get it, the patient looks at me with a nervous look like "she can't understand me" I have to say it's gonna be a good night and leave. I feel awful for the poor person in the bed. They have to be thinking, what the heck am I gonna do, I can't understand her and she can't understand me, what country is this? That's what I would think. Most people don't have to deal with the diverse dialects and accents that we do on a daily basis, it's just not as easy for them to understand the accents. It's got to be scary for them.
I also had a patient who complained of a little chest pressure but denied pain so the nurse did nothing about it. When she told me in report that he complained of a little chest pressure since 6 am and it's now 7am. I got right up, didn't let her finish her sentence, and went to check the patient. I think it was a combination of a lack of experience and a weak grasp on the language that caused her not to act. He was complaining of chest pressure, but had not gotten any nitro and didn't even have any oxygen on, very basic stuff. The patient ended up in the cath lab by 8:15 and had 2 stents to his RCA. For the non-cardiac nurses out there...that's a BIG DEAL. It's scary to think what could have happened if the nurse following her also had a weak grasp on the language or was as inexperienced.
I am not sure that allowing more foreign trained nurse to come and work here is the answer to our shortage. How about making it so nurses want to stay in nursing? How about cutting out some of the paperwork stuff so we can spend more time with our patients and give them the care they need? A lot has to do with work ethic as well, which is lacking in the USA in general. Nursing is a career not just a job. It's bettering people's lives, or trying to at least positively impact them, not spending half the day on the Internet and the other half on your cell phone.
There are lots of great people out there who would love to be nurses and they are getting put on a waiting list for nursing school...then they find something else to do because it just takes too long to get in. There has been a nursing shortage since I started back in 1991...I wish I knew the answers...any ideas?
Non noc nocere.

Another fun in the sun week

2008-08-04T08:59:00.004-07:00

Hey all, how are ya? We are still having a good old fashioned Arizona summer. Very hot but not humid and no rain to speak of. Today is by far my favorite of the last 2 weeks...it's about 85 and cloudy...of course it's only about 8am but, it's a nice change.
I've done a lot of running around the last week...my nephew is here for his summer vacation. His Mom's idea to send him to 110 degrees for a vacation, not mine. We've been able to do a few outside things but, I'm sure not as much as he'd like. I'm glad he is old enough to entertain himself a little. It's really difficult to get used to having another person around 24/7 when it's just been me, my husband and the dog for so long. I think it would have been great if it was only for 3 or 4 days...but it's been 8.
Headed to a baseball game tonight...D'Backs vs. Pirates. I wonder who will win?lol The D'Backs have been doing very well this season again but, my heart is in Cleveland. I also love the Cubbies (ya gotta have a winning team as the back up). I love Chase field though...how awesome is an indoor baseball field? with a pool? and a/c? Only in America.
Work has been ok...only 3 days of work last week, I haven't done that in ages. It was nice to be home. There was the usual excitement of an alcoholic patient with chest pain going into DTs, I had a COPD pt come back from the cath lab after a pacemaker that I had to give Romazicon to...that was a first for me. Never had to give the stuff before, it works like a charm. This poor guy, if he didn't have his bipap on and a pacemaker in he woulda been a goner...one shot of Romazicon in the IV and he was awake and talking. I'm glad my other patients were stable because he took all my attention for over an hour. Not so lucky was some poor lady the day before. She apparently came back from the cath lab along with 2 other patients to the same nurse in a short period of time...all the circumstances are unclear except the end result, they had to call a code on her and she is now in the ICU. Now, that's a bad day.
My problem is with management. We have a charge nurse or CM as they call it. They walk around asking when our patients will be discharged and handing out the admissions without much consideration for the patient or the nurse. If you have 3 empty rooms they will give you 3 admissions. If you have 3 patients going to the cath lab, oh well. No back up, ya know sometimes you are so busy you don't have time to find them to ask for help, but they are so removed from the idea of real nursing in 2008 that they don't get it. These are nurses who have been in their position for YEARS like 10 or 15, they don't understand what it's like to be in the trenches anymore. They always get their lunch break and their 15 minute breaks throughout the day. They randomly dole out the assignments for the next shift without looking at the day before or what kind of acuities they are handing them...I was in lower management for awhile. I know what it's like, but I got in there and paid attention to how my nurses were doing and helped out where it was needed.Just frustrating I guess, to see the patients suffer from a lack of leadership. Maybe the next hospital will be better. I think that's my problem, I think I like a place then the longer I am there, the more I see, and then I need to go. Just a traveler at heart.
Thanks for listening to the ranting...any comments?
Non noc nocere.

Email excerpt

2008-07-16T13:02:00.002-07:00

Just a little bit if the desert for ya. I can't decide which I like best the cactus or the palm trees...you can keep your fall leaf changes and the summer humidity, I'll keep the heat, the cactus and the palm trees.
This is a little excerpt from an email from my favorite nurse:

Long day today. I admitted an Indian woman yesterday from the ER. She had 32 home medications which were not written on the med reconciliation form and No allergy band on from ER. She went to the ICU at 0300 today for respiratory failure. I got her back not bathed, from ICU at 10AM. 25-30 relatives at her bedside. Well at 1820, after being in the room for the last 20 minutes of her life,the nursing supervisor tells the Organ donor bank that she is a white lady. Well,that fried me for some reason and I told him Hey she is no white lady she is Native American. I did not see her grandson standing nearby but, he stopped me in the hall and thanked me for correcting him. She would appreciate it. Long day.

Sometimes it's the little things...they can either make your day or just mess it up. The 32 meds not on the med rec form and the allergy band not on the patient from the ER will most certainly mess up your day. I find it happens a lot from the ER...all over the country. I know they are busy down there, I've worked there a couple of times but, they still need to be held to the same standards as the rest of us...just those little omissions can cause error.
Getting your patient back from the ICU without a bath or at least smelling like they got no bath seems all too common as well. Most ICU's bathe their patients at night but, I have run into some that don't get it at all...maybe it's too basic of a nursing chore for them...that's one of my peeves. I know you are trying to keep them alive and it's really busy but if they are well enough to come to the floor then you should give them the decency to be clean when they get there. Getting a dirty patient half into your shift can really make for a messed up afternoon, cuz then you have to stop and clean them up before the hoards of family members come to see them. Minimal visitors and lots of weird smells in the ICU can mask it for ya but, no so on the floor. Plus, I don't feel like I have cared for my patient if they appear dirty or unkempt.
Just that 2 seconds it took for the grandson to thank the nurse can make your whole day seem worthwhile. After all, it's what we need, just for someone to notice that we really do care. After a long day of family in your face, patients being crabby, poor staffing, nurses whining about their assignments, doctors yelling, and your boss not backing you up, it's nice to hear something positive.If we didn't care, we wouldn't do what we do. Just one sincere thank you for a little thing can make it a good day.
We can do it for our co-workers too...let them know if they helped you, tell them you appreciate it. It just might make them have a good day.
Thanks to my favorite nurse for sharing and for caring enough to be the very best....
Non noc nocere.

Heat is on

2008-07-13T11:19:00.003-07:00

That's right, the heat is on...33 days over 100 degrees. But, the humidity has still been low, until this past week. The rain and clouds and the wind, it's monsoon season finally. All the native Arizonans are soooo happy, they actually go outside to be in the rain.

I have had a long week, the beginning of the week my patients were great and I went home feeling like I did a great job. Yesterday was a different story...just really had people that got on my nerves. It should be ok for me to not take care of someone if they refuse to help themselves. If you know what you are doing will kill you and you refuse to even try to stop...I should not have to help you or put my taxes toward helping you. I have 2 examples:

A 40ish year old male with chronic back pain and a HUGE family history of heart disease. He has already had stents placed in the not so distant past. He comes to our unit for chest pain and continually leaves the floor to go and get his Pepsi (since we can only give him Shasta colas from our floor stock and that's not good enough)...yeah he comes back with a Pepsi but also smelling of smoke. I repeatedly explain to him why it is unsafe to leave the unit, especially when he complains of sob and chest pain when he returns. He has not stopped smoking since he got his stents. So, he goes to the cath lab and comes back needing a CABG. He has had a cath before, his bedrest is only 4 hours and he is doing everything he can to try to get out of it. Then, he's up smoking in the bathroom. He says it's driving him crazy that he can't be the one who decides when he quits smoking, he wants to go home and set a date for 3 weeks from now or so and then he will be able to quit...wow, can you believe that logic? Not even the reality that he could have a massive MI and die is enough for him to want to stop doing what is killing him. Amazing, he doesn't think enough of his life...I know all you smokers out there are saying..you don't know how it is, it's hard...well, yes I do and yes it is hard but you have to want life more than cigarettes. I don't think the residents of Arizona or the US should have to foot the bill for this guy to have a CABG when he doesn't even want to try to quit smoking.

Do I sound angry, or bitter? I also had a female patient come in with chest pain, she's about 40 years old, also a smoker and morbidly obese. She says she goes to see her primary care doctor every couple of months for her high blood pressure. Her glucose level was well over 300 in the ER as well as her urine being positive for amphetamines and opiates. Her cardiac enzymes are way out of range (her troponin which should be less than 0.01 is 57). So, off to the cath lab she goes, her vessels are so bad they had to go through her brachial and even then they couldn't see all they needed to see..but what they did see was not good. She ended up going home on meds because the chances of her being able to survive the CABG were so slim...this woman is also on disability and she's out there getting high and killing herself by smoking and over eating and generally not taking care of herself. I was really glad that she wanted to go home on the meds, I don't think she'll make it which is pretty dam sad to say for someone so young, but she isn't doing a whole lot to help herself either.
I think that's my message for today, and why we as nurses can get burnt out. If people are out there and they know what they are doing is hurting them, yet they keep doing it, why should I have to try to help them when they won't try to help themselves? Why do we spend millions of dollars on healthcare for people who turn around and continue doing what got them in bad shape to begin with? When does the responsibility get shifted to the patient?
Really glad I got the day off today. Kinda sounds like I needed it huh? Remember non noc nocere.

Computer Crash

2008-07-03T11:30:00.003-07:00

So, I had a great day off yesterday, I slept in, I exercised, I got to swim in the pool and enjoy the sunshine. Oh yeah, it's monsoon season...still waiting on some rain. My dog is thrilled that it never rains...she always hated going out when it was wet. Luckily we bought a house with desert landscaping, so, not much water needed there either.
The last day I worked was Tuesday, we really thought it was April 1st not July 1st...I guess we'll call it July fool's day...what a mess. Some how our computer system at the hospital crashed. It started out running really slow when I passed my morning meds...thank goodness it was my second day with these people and they didn't have a ton of meds. I actually got done at about 8:45, and I took a break...yeah I do it when I can because the opportunity doesn't come along too often. By the time I got back there was an irritation in the air. The doctors had started doing their rounds...there was much grumbling and a lot of mouse punishment going on. You know how it is when the computer just isn't responding so you pick up the mouse and slam it on the table a few times to wake it up...yeah it doesn't work people. It's not a real mouse, it's not sleeping, you don't have to wake it up...the problem is in the computer. Maybe I shouldn't tell them that, they'll be slamming the tower against the desk next...lol. So, first it was just taking a really long time for the pages to load, then they are timing out, then you get kicked off, then you can't even sign on to the program so everybody starts rebooting their computers...because communication is sooooo wonderful in the health care field, there have been zero announcements about the computer problems. But, everybody is complaining. Some of the docs are really verbal, " How do they expect me to do my job? None of my patients are going to get discharged today with all this going on, I was going to discharge 10 people now only 4 get to go home." It was getting bad. The we found out it's not just our hospital, it's not just the hospitals that belong to this certain company in the Phoenix area either. They have hospitals in AZ,CO,WY,NV,CA,AK and they are all down...what a nightmare. Plus the hospital where I work has only been live on the computer system for nurses to chart for about a month...so, there are a lot of people not comfortable with it yet. Now they are being asked to go back to paper charting until the computer comes back up....what a headache!!! Thank goodness my patients were angels and didn't need much charting. The issue was completely resolved at about 6pm just before night shift came in. And they got an extra nurse to help them....WHAT????!!!! the problem is solved what do they need an extra body for? Maybe, the band aid might not stick huh? SOOOOOO glad I had a day off yesterday!!!Guess we'll see what happens when I go back tmorrow.
Remember our troops and have a Happy and safe 4th!!!
Non noc nocere.

IT'S HOT!!!!!

2008-06-23T10:36:00.003-07:00

Yep, it's summer in Arizona. I wasn't sure how bad it was going to be and I'm sure I haven't seen the worst of it yet...this past week the average temp was 112. I didn't mind much because I was at work...but we did have a couple of admissions from heat stroke. I had a guy who likes to keep his apartment at 85 degrees and actually called his maintenance guy because there was a draft coming from the fan in his bathroom(WHAT???). His rectal temp on admission was 104.8...nice...and he has 7 college degrees.Bright but not smart.
My boss is trying her hardest to get me to come on staff. I have a really hard time with that. I have been traveling for 7 years now and it would have to be a really exceptional place for me to decide to stay. I had a day last week where I got my cath patient back at 6pm. She had an ablation so she came to the floor with one arterial sheath and 5 venous sheaths in. She was oozing when she got to the floor, I was so thrilled. I called to get my CM (charge nurse) to come up and take a look at her. The CM's get report at about 6:30 so they are usually off the floor at that time. Well, they didn't come to help me. One of the internal med docs came to see the patient and was not happy about the amount of oozing so he called the cardiologist who said pull the sheaths. Ok, well, the patient has been on coumadin her INR was 2.6 and they had given her heparin during the procedure...not a good combo for pulling sheaths..plus it's the end of the shift and I don't pull sheaths.So, I call the CM again..it's now about 6:30. She finally gets there at about 7:20 and says oh it's not so bad...then she takes the dressing down....yeah, she realized then that she should have come up a long time ago to pull them...she pulled at 7:29. Yeah, I know what you are thinking "but, your shift ends at 7:30" yeah most days. I did end up getting out of there about 15 minutes later because the house sup came to help the CM hold pressure. I'm pretty sure they were there for a LONG time. So, that's just one example of why I would not jump at the chance to become staff.I don't feel I have the resources I need to provide the best care for my patients.
There are a couple of other hospitals close by that are in a different conglomerate...they are CHW hospitals. I have an orientation there through my agency the middle of July so, we will see what happens with that. The only time I have had a problem getting a contract here in Phoenix is in the summer and my contract ends the end of August so, I am not too worried.
As always, first do no harm.

Moved in and moved on

2008-06-09T09:55:00.004-07:00

So, this is a picture that my husband took of our friends when we went on our boat trip. Jeannie has the hat on and Don is her husband (sitting behind her) and Shirley is sitting next to Jeannie. Jeannie and her husband went back to Napa to be with their daughter. It's been a little over a week and I still really miss them. It was nice having friends in town. We moved into our house officially one week ago, last night I got to sleep in my bed.. it was wonderful. When I came home from work I went out back and put my feet in the pool for a while. Then we sat on our double chaise lounge under the stars and talked. The temperature was about 75 or so it was very comfortable.
I had 8 days off (to move in)and then worked 4 in a row. I don't like working 4 in a row. I get really crabby on day 4...I had the same patients for almost the entire 4 days, which, in a perfect world would be great, but, I had the drug seeker who would follow me around in his wheelchair ( I still would like to know who gave him a wheelchair) and ask if it was time for his Dilaudid; I had the slightly confused old guy who cried and complained all day about how awful he felt, no matter what I did or what meds I gave him he felt awful, but he watched tv and ate ice cream at the same time; and the 300+ lb woman with a chest tube who had to be lifted from her air bed to the chair for all her meals. So, it was a very long 4 days.
Today I plan to catch up on some emails and to sit out by my pool. I am scheduled again tomorrow and the next day. Census dropped a little during Memorial day but, we have been full ever since. My boss is trying to get me to go core staff...she has had a traveler there for the last 3 years who is still there and there was another one that moved to a different floor this month who had been there for 2 years...so, I am not going to cave...there are plenty of travel jobs in this city...yes, I like this hospital but, not for a $10/hr pay cut.
Well, hope ya'll have a great day. Remember first do no harm.

Loss

2008-05-24T10:59:00.002-07:00

Above is pictured my favorite Uncle. He had a battle with cancer and copd for the last year.He was put in hospice on Thursday of this week and passed on Friday. It makes it all too clear that you must live your life not just be alive. He had a surgery last year which made it possible for him to travel and visit friends and family. The other lesson this has brought home to me is take care of your body and it will take care of you. You cannot over indulge (in anything) and expect not to have any consequences. Ok, I'm off my soap box. He was a great guy, always had a big smile and a kind word. He had a fantastic voice, bass baritone, I loved to hear him sing. I took a travel assignment last year in Columbus Ohio to be near him and my brother and to buy our house there. I am so glad I got to spend that time with him. I hated the job and the weather but it was worth it to spend that time there.
Thanks for listening.
Remember our troops and all those who fought before them...it's Memorial Day. Be a proud American!!!
Non noc nocere.

Marathon for computer charting

2008-05-20T11:41:00.002-07:00

Well, I made it. We are the last of the Banner hospitals in Arizona to go live with their computer charting. I worked the whole first week. Since I used the system before I got to be a "super user" and spent the last 3 days of last week helping the nurses find their way. I have a new appreciation for those of you who know how to type, even just a little. The hardest part was helping to teach those who don't use a computer at home on a regular basis. If you have to study the key board to find the letters, you should have practiced. If you cannot click and drag, you should have practiced. If you cannot scroll without clicking your mouse a bazilion times, you should have practiced.
The biggest thing I learned, a new tool doesn't change old bad habits. If you want to pull all your meds for all your patients for the whole day, you'll still find a way to do it, even with a newer better system. If you didn't check the meds against the mar and check the name band before you gave them before we got computer charting...you won't now.
All I can do is never let my family members go to the hospital or stay in the hospital alone.
Non noc nocere.

Happy Nurses Week

2008-05-05T10:51:00.003-07:00

Well, it's that time again. Nurses week, it used to be a day...now it's a week. The hospitals usually give you some free food and some free stuff and say they appreciate us. I think about god old Florence, she did it because she cared about people and wanted to make them feel better when they were sick and hurting. I'll bet her patients were mighty grateful for every little thing she did for them. Her nursing was about fluffing the pillows and keeping them clean, dry and warm. Have we lost sight of that somewhere along the way? Some days it seems like nurses just come to work to see their friends and check their email or surf the Internet. Some days it's like we are there just to pass out pills and food. This May 6th (Florence's birthday) I am going to honor her by wearing all white. I try everyday to be the best nurse I can be to my patients. Looking back, yeah there was a time in my career that I cared more about seeing my friends than taking care of my patients. Traveling has helped to cure a lot of that, when I start somewhere I don't have any friends to worry about. I focus a lot more on my patients needs than what the other nurses did over the weekend. I think that's what it's about. Being the best nurse you can be, every day, like Florence did. Have a great nurses week!
Non Noc Nocere

The Code

2008-05-04T18:48:00.003-07:00

Hey all...yeah it happens to all of us. I was transport nurse for 8 hours then took over for a nurse that went home. Things were great at 4pm...all of my patients were happy and healthy just waiting to go home in the next day or so. My best patient had finished her walk around the unit with her chest tube and was sitting in her chair visiting with her friend... when her friend came out and said that her friend (my patient) felt dizzy. I went immediately to her room after checking the monitor and she said she felt dizzy, we immediately got her back to bed and by then she couldn't complete a sentence and her pupils were fully dilated. We coded her for about a half an hour. Thank goodness her friend was there because she was in PEA for a while. It was devastating to me. I hate to code patients,especially my patients, but this one I knew there was nothing I could do. As we laid her down in the bed, she couldn't form a complete sentence, and she looked into my eyes and started to cry. It is really a strange predicament to be in. But, it really makes you think of your life and how quickly it can change. (She didn't make it)
Ok, on to better subjects...today is my birthday. It has been a great day..ok so all of my siblings didn't call or email me happy birthday..but my friend Jeanett called from Ohio to say she missed me at the Louie Run today ( a motorcycle ride named for a guy in North East Ohio that benefits lots of different charities) and my friend Frank called from Kentucky. Frank has the same birthday as me and is married to one of my best friends Frankie. We took a boat ride on Saguaro Lake with our friends Don, Jeannie, and Shirley. We had a great day and went to the marina diner for lunch and it was a great day.
I am still waiting for the bank to decide if I am going to get this house or not but I am finally stabilized here for another 3 months...at least till the end of August. So, another year and none the worse for wear. Non noc nocere.

Waitin on a contract

2008-04-26T10:47:00.002-07:00

So, I'm waiting on 2 contracts right now. Number one is for the house pictured above. It is in the neighborhood right next to our apartment. It is a foreclosure and has been vacant for a year. Yeah, the pool is a little low and green... the weeds are a little high in this picture...luckily the HOA has since cut them down for us. The inspection is done but we are still waiting for the OK from the lender...so that's one contract. We are hoping to buy this house at a discount, live in it for a year or two and then sell it for a profit.
The second contract I am waiting for is from Banner for an extension to stay working at the hospital I am in now. About a month ago I asked my boss if she needed me for the summer and she said she wouldn't know for a few weeks. So, now that it is getting close to being a month away from the end of my contract, and with everyone elses contracts ending the end of May too, we are all getting a little nervous. I would just like to be able to stay at this facility for a little longer. I like the people I work with for the most part and the work is not very annoying. Let's just say I can tolerate it for a few months longer. At a increased rate of pay, because I will get a housing stipend instead of an apartment...that stipend should pay my mortgage, plus I will still get my same hourly rate. Of course at the other end I will not get a bunch of write offs for my next years taxes but, I'm ok with that.
All that aside I had a very phlegm filled week this week. Our cardiac unit has turned respiratory on me. I had 2 COPDer's , one CP and a suicide. Yesterday my suicide was discharged to inpatient psych and I got an ESLD. My least favorite was the 49 year old Cerebral Palsy patient...he was nice enough but barely functional and just coughing and coughing and I was so afraid he was going to choke when I fed him. Speech therapy said he was ok, just a delayed swallow, just not in my comfort zone. But, I have 2 days off and next week is another week.
Remember non noc nocere.

Poem Crabby Old Man

2008-04-22T10:42:00.002-07:00

This is a great story whether true or not...

When an old man died in the geriatric ward of a nursing home in North Platte, Nebraska,
it was believed that he had nothing left of any value.
Later, when the nurses were going through his meager possessions,
They found this poem.
Its quality and content so impressed the staff that copies were made and distributed to every nurse in the hospital.
One nurse took her copy to Missouri.
The old man's sole bequest to posterity has since appeared in the Christmas edition of the News Magazine of the St. Louis Association for Mental Health.
A slide presentation has also been made based on his simple, but eloquent, poem.
And this little old man, with nothing left to give to the world, is now the author of this ' anonymous' poem winging across the Internet.
Crabby Old Man
What do you see nurses? .What do you see?
What are you thinking.....when you're looking at me?
A crabby old man, ...not very wise,Uncertain of habit ........with faraway eyes?
Who dribbles his food.......and makes no reply.
When you say in a loud voice.....'I do wish you'd try!'
Who seems not to notice ..the things that you do.
And forever is losing .......... A sock or shoe?
Who, resisting or not...........lets you do as you will,
With bathing and feeding The long day to fill?
Is that what you're thinking?
Is that what you see?
Then open your eyes, nurse......you're not looking at me.
I'll tell you who I am . As I sit here so still,
As I do at your bidding, .....as I eat at your will.
I'm a small child of Ten.......with a father and mother,
Brothers and sisters .........who love one another
A young boy of Sixteen .with wings on his feet
Dreaming that soon now. ......a lover he'll meet.
A groom soon at Twenty ..my heart gives a leap.
Remembering, the vows......that I promised to keep.
At Twenty-Five, now ........ I have young of my own.
Who need me to guide .... And a secure happy home.
A man of Thirty ......... My young now grown fast,
Bound to each other ...... With ties that should last.
At Forty, my young sons ..have grown and are gone,
But my woman's beside me.......to see I don't mourn.
At Fifty, once more, . Babies play ' round my knee,
Again, we know children ....... My loved one and me.
Dark days are upon me .. My wife is now dead.
I look at the future ..............I shudder with dread.
For my young are all rearing......young of their own.
And I think of the years....... And the love that I've known.
I'm now an old man.........and nature is cruel.
Tis jest to make old age look like a fool.
The body, it crumbles..........grace and vigor, depart.
There is now a stone........where I once had a heart.
But inside this old carcass .. A young guy still dwells,
And now and again .......my battered heart swells
I remember the joys........... I remember the pain.
And I'm loving and living.............life over again.
I think of the years .all too few......gone too fast.
And accept the stark fact........that nothing can last.
So open your eyes, people .......open and see..
Not a crabby old man.
Look closer....see........ME!!
Remember this poem when you next meet an older person who you might brush aside without looking at the young soul within.....
we will all, one day, be there, too!

More days off

2008-04-09T10:52:00.003-07:00

This tomb is in Papago park next to the Phoenix zoo...it is a great place to look out over the city...especially at sunset. It was one of our stops with my niece because it's right next to the hole in the rock.
I had another 3 days off this week for my husband's birthday. We didn't do anything spectacular but we did go house hunting. Hey, what can I say ,it's what he wanted to do. We found a cute little house right down the street from our apartment that has been vacant for almost a year...sounds about right for us. It is a 3 bedroom 2 bath with a pool...we'll see what happens.
Work has been frustrating because we still have our doctor's father. I feel badly for the doc...trying so hard to keep dad comfortable. We have been having some staffing issues...people not showing up for their shift and late call offs. Sometimes it can't be avoided...and I prefer if you call instead of not showing up at all or coming in and then leaving because you don't feel well. You know you don't feel well when you get up so, just take the points or the attitude from the staffing people and call. Don't, don't, don't think you will feel better once you get to work because you will just end up going home and leaving everyone in a worse position.
I have to ask...how many people will go into work if the staffing office calls you and asks you to come in? Does it depend on how you feel? How much they beg? Do you even answer the phone? Would you be more likely to say yes if they called you the night before if you are a dayshift person? When is a good time to call a nightshift person to come in? How likely are you to stay a couple of extra hours if you are already at work and the next shift is short?
Here's my position. I will pick up extra days when it is convenient for me...not 4 in a row or more ...don't even ask me if I have been there for more than 2 days in a row. Call me the night before if you have an idea...I will most likely not come in if you call and wake my butt up at 5:30 am and ask me to come in. Now, when I was working agency, that was the norm, I had to wait for them to call and tell me where I was going to work that day so I was up anyway. It also depends on my wallet...and how much cash I need. What's your take on it? Just wondering.
Remember first do no harm.

Desert in bloom

2008-04-01T10:07:00.003-07:00

What a great week! We went for a little nature hike one day and got to see the desert in bloom...some really vibrant colors. Not a lot of color, which makes it even bettre just splashes here and there. I had so much fun sitting by the pool and shopping with my niece. We took her to a little restaurant that we had gone to with our friends. They serve a lot of senior citizens...lots of cheap food...it was fun. We went to the workout room at the apartment complex and played racket ball as well. It was fun playing the cool Aunt.
Went back to work on Saturday and Sunday, nothing too exciting. The boss actually came in on Saturday. She told me one of my crazy patients had called administration and told them how nice I was. Yeah, how much weight does that statement hold when they know he's crazy? Does it just show my attraction for the bizarre? This is a guy who has been admitted to the hospital 15 times since the beginning of the year...not to mention all the times he was in the ED and was not admitted...for chest pain. When I had him he got a Psych eval and the Psychiatrist even said he was and odd bird...she couldn't tell if he was schizophrenic, drug seeking or just plain odd.At least he didn't tell them I was crazy,huh?
Headed to class today...at least I got to sleep in. It's a refresher so, hopefully I'll retain something. Then tomorrow, it's back out to the pool. Yeah, traveling sucks.
Remember first do no harm.

a week off

2008-03-25T10:44:00.003-07:00

Yep, a whole week off...one extra day cuz I was sick. Beware of food brought in for "pot luck". I usually have a pretty strong stomach, but it really got me. Easter dinner...better with family. So, my neice is here for a week. I get to play the cool Aunt..as close to being a Mom as I ever wanted. Seems weird what with everyone else in my family having one or more off spring. I'm lucky I just get to enjoy them all. So, we will be spending a lot of time at the above scene...the pool, so she can got back home to the frozen north with a little tan and make her friends jealous. My oldest sister is in the happiest place on earth...Disneyland...don't envy her. She is there with her 4 kids and 5 grandkids...sounds like fun to some...can't wait to see the pics. Be safe and find some time to enjoy a day off.
Remember non noc nocere.

Busy,busy,busy

2008-03-20T10:07:00.002-07:00

Well, this is one of my favorite places...it's called the hole in the rock. It's in Papago Park in Phoenix. It doesn't look like it from this picture but you can stand in the hole and look out over the city. We stopped there on our way home from a baseball game last week. Yep, baseball is alive and well in the Cactus league..we saw the D-backs and the A's. It was actually a pretty hot day...about 85 and sunny.
My nephew has made the trip to Iraq...he is currently about 11km southeast of Baghdad. Still doesn't seem real to me. Please keep him in your prayers.
Got some bad news from a traveler friend, her husband's sister's body was found Tuesday near a lake in York PA. She was a high school teacher and had gone out for a hike Sunday and went missing. They suspect foul play but are awaiting the autopsy results.It just makes me shake my head, what is happening to this country when you can't even go for a hike in rural PA and return safely? Please also keep them in your thoughts.
I've been working my 4 to 5 twelve hour shifts a week. It's been really heavy at work...one of my patients was on the floor the other morning when I went in to see him...ya gotta love to start your day that way. We had to use the Get-a-lift to get him off the floor...he's a big guy and really sick too. I was really impressed, even the nurse manager came in to help. I've had a couple of nice old guys the last couple of days as well, they love to talk about the state of the country. I love to get the time to talk to them, some of them have such great stories.
Well, headed out to the game again...Cubs vs. Rockies...be back with pics.
Remember first do no harm.

One of those patients

2008-03-02T16:47:00.003-07:00

We've all had them...the patient that just won't leave...every time you go into work you just hope they have gone home or to another floor or anywhere that you won't have to take care of them. It's not that they are a difficult patient or even really sick...maybe that's what irritates me. I like my patients to come in sick and go home better not linger in annoyanceville forever. Mine most recent one is still on the unit and I have had him everyday that I have worked now for 2 weeks straight. He has TGV(transposition of the great vessels of the heart) and he needs a transplant...the doc is trying to prove it by bringing him in and putting him on dobutamine, now he's dobutamine dependant. It's a fight with the insurance where to send him for the transplant...but he's not even on the list yet. Makes going to work just a little more annoying.

Had a great trip to Las Vegas...saw the new Palazzo and a great little place just off the strip called Tuscany.It's always changing, they are building a lot of new stuff. We followed our friends advice and took the southern route from Phoenix into Las Vegas. We got to go through little towns like Searchlight Nevada...plus we hit Arizona, California and Nevada...always a plus to hit as many states as possible in your travels. The ever present question...did we win...well, yeah we won some we lost some but, it didn't affect our financial standing so, it was a good trip. Still waiting to hit the big one...as always first do no harm.

CPR

2008-02-10T10:17:00.001-07:00

Nothing wakes you up faster in the morning than a code.It was not my patient but I found myself there in the room...the monitor looked like V-Tach and the alarms were going off.I went quickly to the room asking who's patient she was. I looked at her and knew she was not breathing. My second responder (her nurse) entered the room and I told her to call the code...I flattened her bed and suddenly the room was full of people...the ambu bag was being tossed to the head of the bed, as I was putting it together the resp. therapist appeared and started bagging. I started the compressions, then came the AED pads and finally the backboard. I asked for a switch and the next person stepped in after the first shock...still no viable rhythm. More drugs ,more CPR, the ET tube was finally in and another shock and she was back...now, the entire room is completely full of people,student nurses are in the door way looking in with a look of shock,terror, and awe on their faces. You know they are thinking I hope that never happens to me. Well, me too but, it will. The patient was sent off to the ICU. Our patient population is getting older and sicker and the people who are in the ICU's are ones who would have been dead 10 years ago. So, the ones on the PCU's and Tele and SDU's are the ones who would have been in the ICU 10 years ago. And the patients on your med-surg floors would have been in the SDU or Tele floors and the ones who would have been on med surg are now in skilled nursing facilities or rehab centers and so on. It's scary to me, but it's reality. This is the second code I've been in since January when I got to this hospital. 2 codes in 2 months, those aren't good odds. I hope that pattern changes.
I have decided to stay here in Arizona until June, well, actually, the hospital asked if I'd stay and I accepted. Yeah, it'll be pretty hot by then,but, the money is good and the overtime is avaliable. This hospital is changing over to computer charting just like Good Sam did, so, luckily I already have had the classes and worked with the system...am easy transition for me.
Our little house in Columbus is still on the market,but we have started the search here for another one. It's a buyers market so, we hope to profit from that.
Remember first, do no harm.

Barrett Jackson '08

2008-01-24T18:14:00.001-07:00

If you watched any of the Barrett Jackson car auction last week on Speed..you saw this boat. No, that's not me in the pic but I was there. I love being in Scottsdale in January. I cannot get enough of the cars. I remember watching it years ago before I started traveling... and just thinking how great would it be if I could go and see all those cars. And, now I've done it three times...I could walk around there for days. You could tell people are holding on to their money this year because not many cars got over $500,000. Still, it's a fun thing to do.

Work is going well, I am getting in all the extra hours I want. The floor is laid out well and they are all private rooms. No more taking care of the patient in the bed by the window and the one by the door, who is someone else's patient, asks you for something every time you go in the room. The patients are mostly cardiac, there's a little med-surg thrown in there for fun. I can't tell you how nice it is to take care of an uncomplicated cath pt or even better and AICD or a pacemaker. Yeah, the patient turn over is pretty quick but, I love it. The charge nurses are very helpful and my coworkers are friendly. I had to float the other day and they were even friendly. There are quite a few travelers and most of them are Arizona residents. It's interesting, some of them have been there over a year..pretty unheard of in other parts of the country.

The apartment is very nice and quite. It's great having our friends in walking distance. We are headed to Vegas the end of next month...lots of working till then.

First do no harm.

New assignment

2008-01-08T11:11:00.000-07:00

This is just one of the great pics sent to my by my nephew from his training in the desert in California. I know he worked his butt off and I hope all the training will keep him safe when he has to go to war.
I had my first day of orientation yesterday at Desert Hospital in Mesa. I so got off the hook. Since I just left Good Sam I didn't have to take any tests or stay for the computer class. Yeah! I didn't even have to get a new badge..I'm most happy about that. Lets face it, I have to get a new badge just about every 3 months. I do not photograph well most of the time so, when I get a picture I like I want to keep it. So, even though it was raining it was a good day. I was there about an hour and a half, got to see the unit where I will be working and met the manager. Then I was pretty much done. The rest of the week looks to be measuring up pretty much the same. I work about 8 hours tomorrow and 4 hours on Thursday. I get to orient of Friday and Saturday then on my own on Sunday...pretty easy week...then only 12 more to go.
Love, love, love the new apartment. It's so quiet and it's nice to have friends so close by. This place has a great workout room...lots of weight machines and 3 treadmills, 1 bike, 1 elliptical and 2 racket balls courts. I talked my husband into buying rackets and he actually went with me yesterday. We had a blast..next time we are going to look up the rules before we go. We just had a great time trying to hit the ball...neither one of us got hurt too badly. I got him in the nose with the ball once and we each got ourselves a couple of times. But, we stayed there for an hour!
I can only hope that trend continues!
Remember first do no harm!

Happy New Year

2008-01-01T12:13:00.000-07:00

Happy New Year all. We had an awesome New Years Eve. I worked until 7:30 but it was an easy day. We drove to our traveler friends apartment..we were a little worried because or the Insight bowl ending in Tempe (yeah Pokes!) and road closures for the block party afterward. Luckily the freeway was not too busy and we got to our destination without a problem. It was a nice quiet evening, some tv and some poker with a splash of Napa Valley Sparkling wine. I hope it was a great night for all of you as well and I hope you all made some good resolutions. May the year of the Rat prove to be prosperous for all of us!! Non noc nocere.

Christmas spirit

2007-12-24T10:48:00.000-07:00

There really is a Christmas spirit and it is alive and well. I have to share this story. A nice little old (80) lady, healthy and does everything for herself, lives alone. While driving to church, somehow got off the freeway before her exit, as she was driving down the road she runs into the curb and stops. A man following her stops and walks up to her door and asks if she needs help. She feels confused and says I don't know. He walks her to his vehicle, helps her inside then goes back to move her car to a parking lot. He asks where she was headed and she tells him to church, she is starting to remember now, at first she gives him the right name but the wrong address, then she says no and gives him the right address. He drives her to church and along the way calls her son to tell him what has happened. The stranger walks her into church and helps her sit down, then he's gone...She gets help from the other parishoners to get communion then to sit back down. Her son comes in and sits next to her, after the service she asks her son to take her back to her car...he says I think you should go to the hospital, she actually agrees and takes her to the hospital. She is doesn't remember why she turned off the freeway, that few minutes are just gone...but wow, was she lucky. All of her symptoms are gone and it was most likely a TIA but, how badly that scene could have turned out. It really made my day to hear that story.I hope it helps renew your belief in Christmas and the good left in the world. Merry Christmas and non noc nocere.

what do you think

2007-12-18T15:36:00.001-07:00

Yep, that's me, Standing on the corner in Winslow Arizona...we stopped there on our trip back from Oklahoma in November. We had stopped in Winslow before but never went to the corner. It was a nice day...a little cool then but they have been getting snow lately, it's up in the high country. Just one of those places you have to stop and see.

So, here's the scenario. 56 year old hispanic male comes in post op from ortho surgery after trauma, lets say he was hit by a car, it was a right femur fracture. He gets 2 units of blood post op. He codes at about 1am and doesn't make it. No real medical history to speak of. The first unit of blood was hung at about 1330. The second not until 1900. His iv infiltrated at some point in the afternoon and that's why it took so long for the second unit to go in. A couple of side notes...the same tubing was used for both units of blood. The tourniquet was accidentally left on his arm for over an hour. There was still a pulse in the arm. So, what do you think killed him...and what was the worst nursing error. What would you do if these were your nurses? or your family member?

first do NO HARM

GSW

2007-12-08T12:01:00.000-07:00

Another sight on I-40, the largest cross I think in the Northern Hemisphere...in Groom Texas. You know everything is bigger in Texas. My husband just loves these action shots at 80 mph driving down the freeway he'll just pull out his camera and get a shot like this...amazing.
Ok, I know it's the holiday season and we should all be of good cheer and all that but, this week has just blown me away. This trauma stuff is just pitiful. I can't tell you how many gunshot victims I have taken care of this week. And most of them have no insurance, so the wonderful state of Arizona will help pay their bill. But, you have to give them all your info like a bank statement and your birth certificate...hard to find when you are laying in the hospital after being shot. So, you get to sit there until we can find someone to get the information and then the process takes like another week.
Then there are the illegals. I spoke with the case manager this week. We have a couple of people who need to go back home...and it's not going to be a short trip. $38,000 by ambulance. The hospital tried to send one person back yesterday with a medical person to transport by commercial airplane but, they wouldn't let him on because he didn't have a passport....duh, he's going back, he didn't have a passport to get here...how do we send him back now? I say call Sheriff Joe. Just really frustrating.
Then someone tells me that Santa Claus is not allowed to say HO HO HO anymore. What is up with that? Are we afraid he's going to offend someone? He has been saying HO HO HO for hundreds of years...the hoes know he isn't talking to them. Are we that afraid of offending someone, anyone? Now he's supposed to say HA HA HA...well, who is he laughing at? Yeah, are you laughin at me? Yeah, that's so much better.Ugh. It's hard enough for me to muster up some holiday spirit then I hear something like that...just kills it.
I'm looking forward to moving to a different hospital. I will be going to Banner Desert...sounds warm huh? It's in Mesa just south and east of Phoenix. We will be getting a new apartment...yeah no more music at 3am...I think any other company would have moved me to another complex as many times as I have complained...not real happy with Banner right now. We will be in the same complex as our friends from PA. The weather here has been pretty cool and a little rainy but still better than 30 degrees and snow.
My computer guru husband added a couple of things to my blog to make it a little more interesting. Can you find all 3?

Holiday trip

2007-11-28T08:57:00.001-07:00

We made the trip from Phoenix to Oklahoma mostly on I-40. There are a few attractions on I-40 in Texas that you just have to stop at once. We actually made a couple of fun stops just to break up the monotony of driving. One was the famous Cadillac ranch..it's by Amarillo on I-40. It was a sunny day and about 40 degrees figured we could brave it easily. Wow, we forgot about the wind..it's one of those winds that no matter which way you turned it was still in your face. Of course we weren't the only ones to stop, there were plenty of people braving the cold. There are 10 Cadillacs buried nose down and completely covered with graffiti..we added ours with a Sharpie...no spray paint available. I'm glad we stopped when we did...I had suggested stopping on our way back but when we left to come home we left at 6am and it was snowing. The pics turned out pretty good. We also stopped at the Continental Divide on our way east...no real picture taking spots there.

We had a great time in Oklahoma. It was great to see my family. Pulls at the old heart strings when you leave though. On the trip back we stopped in Winslow Arizona and took some pics there...they'll be on the next blog. Having trouble with windows vista and windows xp, they don't see to want to play together. I have to get my live in computer geek to help me.

Still waiting to go back to work...I signed up with the agency for Monday Tuesday and Wednesday...no needs...I called the hospital where I am contracted and no luck there either. I start my week tomorrow, so, we are going to find something fun to do today.

Non noc nocere.

Thankful

2007-11-22T09:46:00.000-07:00

Happy Thanksgiving all. We made the 16 hour trip to visit family in Oklahoma City, I actually got to drive a couple of hours. I am thankful for so many things...all my wonderful family, my friends, the ability to work and persue my dreams. With all the bad things we as nurses see on a daily basis, it make me thnkful for the littlest things. Hope ya'll have a great holiday and be safe wherever you travel. Thanks to those who are working today.

So Close

2007-11-04T11:25:00.000-07:00

Looking good,huh? I spent a few days in Columbus this past week trying to help my husband finish up our house. It was a great feeling to help out. I wish time were slower. It's funny how when I am at work time is so slow but when I was at the house time flew. The last thing to do is sand the floors, we got most of the painting done while I was there. As you can see above we got the new counter tops in and a new sink with stick on tile back splash...doesn't look too bad does it?

Work has been pretty good. I have mostly been on med surg overflow...with all the other travelers so work has been fun. I have said for years I would love to open a hospital that has only experienced travelers working there. As a whole we seem to be very flexible easy going people. In general we don't complain when we get an admission or have a busy day. We ask for help when we need it and remind our fellow nurses of things that weren't done rather than writing them up. I know there are some exceptions but for the most part I would rather work with travelers than staffers. I hope that doesn't offend anyone. To their benefit, staffers do know the little subtle things of the unit and usually share them with the rest of us.

Did have some interesting patients this week. More GSW than I have had in my entire career..4 this week. Had a tough guy who had an off roading accident and sat at home for 10 days with a hemopneumothorax and a torn spleen. Amazing what drugs will do huh? Positive for meth and marijuana on admission...but how else could he have been able to stay home with that pain? Yeah, he's pretty tough, amazing he's still alive. I also had the pleasure of caring for a very sweet young woman who has recurrent melanoma with mets to the brain spine and lung...shes so positive, but it still tears at your heart. I know the ultimate outcome...just makes me sad. No other days on tele here at Good Sam although I pass my friends in the halls, I don't get to work with them.

The weather is beautiful. I have good friends here. I miss my family and most of all my husband. But, I continue to work to help us reach our goal of being financially free. Thanks for reading and coming along for the journey. Non noc nocere.

Workin and waitin

2007-10-20T09:39:00.000-07:00

Yeah it's hard to tell but the walls are painted and the woodwork is being salvaged. I guess we a re restoring and remodeling. Wish I could be there for the transformation more. It's coming down to the wire. I imposed a deadline to try to help speed things up. Hopefully my husband will be out here in Phoenix in the great weather by Halloween. Lots of little things left to do, paint, counter tops, ok some big things left to do too. We still need stairs out the back of the house and all the floors except the kitchen are hardwood and need sanded and stained. Some days I think it's easier to be here working.
Yesterday was not one of those days. I have been complaining about not being on tele, well, you know what they say about paybacks. I had 2 people go to the cath lab one after the other. My first lady came back with no closure device and had to be flat for 7 hours. She was nice enough to go into flash pulmonary edema and had one of those doctors that won't call you back. This poor old lady needs an aortic valve really badly. She had been NPO all night getting IV fluids at 125/hr. So, by the time she got back from the cath lab and I turned them to his prescribed rate of 100 for 3 hours , she got about 45 min of it before she started coughing and her lungs were crackles all the way up...just freaked me out. I called the doc for 45 min then I got the clinical manager. This poor little thing, her sats were in the low 80"s on room air. By the time we got the doc on the phone and the lasix in her her sats were 91 on 4 liters. Then, the jackass is like all worried about her and calls to check on her a couple of times. Then, he shows up at like 6pm and has to borrow my stethoscope to listen to her lungs. The patient tells him what a great nurse I am and he says yeah she is and caring too. What an ass. The poor thing has a long road ahead of her Monday she's having TEE,a pacemaker, an aortic valve replacement, and a MAZE procedure...she is 85. Tell me your thoughts on that...she is alert and oriented still lives alone and her family is very involved in her care. How would she fair in Hillary's world?
While that is happening I got a 32 year old who was admitted the nite before to the ICU for bilateral pyelonephritis and urosepsis. She had dopamine to keep her bp up and it infiltrated..they used the ante dote to save her skin. They sent her to med surg and when she got there her bp was 60/40...so we'll send her to tele for the dopamine this time. Oh, she needs a PICC but they are backed up so, she has IV fluids going at 250/hr and she needs another IV for the dopamine. The PICC nurse is arguing with me on the phone that the doc needs to come and put in a central line if she's that sick, he's really busy and won't get to her today. We get a second line in her but itsonly a 22. She is a pain in the butt rolling all over the bed. By the end of my shift it went bad. I tried to get another line twice and had to leave the next nurse with the same thing I got...one line but dopamine, IV fluids and antibiotics to go in. All this fun on no break and no lunch yet at 2:30 in the afternoon.
I got my second pt back from the cath lab...luckily she is ok and had gotten a closure device. But 2 hours into her 4 hour bedrest she starts crying and getting nauseated because her bladder is full and she can't go. No orders to straight cath her of course, I get the doc who says bladder scan her and if it's greater than 200 straight cath her. Meanwhile her bladder is hard as a rock and she's starting to lose her lunch...yeah I straight cathed her...850cc later( I clamped it off so she won't spasm) she is happy and smiling. Got a total of 1250cc from her. Bladderscan her...what am I stupid? Let's see him sit in a bed flat on his back being pumped with I fluids at 150/hr, after being given medicine with a side effect of urinary retention. And he has to wait for some doctor to call me back (at least a half an hour) only to give a stupid order to bladderscan him. So now I have to go find the machine (which takes at least another 10-15 minutes because every floor doesn't have one)to mash on his bladder (which hurts like heck because it's being stretched to capacity) with a cold hard ultrasound probe that weighs about a pound and a half, only to discover, that he needs his bladder emptied...oh, let me just wipe all the ultrasound gel off then go and get the straight cath kit and hope no one stops me and asks me a question or to do anything else for you while you lay there in agony. Guess they don't think about it because they never have to watch the patient or the family wait for the call back from them.
So, that was my day yesterday..oh plus I had a patient who went to dialysis and came back and wanted to go home but no doc I called would write the orders and I had discharged someone at 10am. Ya gotta love nursing.
Non noc nocere.

Just Work

2007-10-12T16:28:00.000-07:00

Just biding my time...I have been working 4-5 days a week. I have worked a couple of shifts at Paradise Valley a little north and west of Phoenix. It's a different pace and a different clientele. The staff is really nice and it's paper charting so it was easy to pick up. I got sent home today from Good Sam...not really happy about that. I've been to Rehab and neuro and today to same day surgery/ procedures. I love working in same day procedures, start iv's send some labs then they leave and someone else finishes the job. We are still trying to finish our house and we need the cash flow, so I called the agency I work for to try to get 4 hours in..no luck, guess I'll have to watch baseball.

The house is coming along slowly but it should only be another 2 weeks...that sounds familiar, have I said that before? The kitchen is the next big obstacle but the island is already completed so we are part way there. That's the picture above..it was hand crafted by my awesome brother.The there's some painting and the floors.The next question is whether to rent or sell...we'll leave that up to the experts.

I have seen a few of my friends since I have been back here in Phoenix. It is nice to see the familiar faces. Just wishing I could work with them more. The floating thing is ok but it's already getting a little old. We'll see what happens.

First do no harm.

Working away

2007-10-01T19:08:00.000-07:00

Work at the house continues, slowly the rooms are getting painted and the little things are getting done. Not fast enough for me or my husband though. It's been a long time apart to get this done. I know it will be worth it in the end. Just hard right now.

Hey all, the weather here has been great. Nice and cool in the mornings still a bit warm in the evenings but you won't hear me complain. I worked at my travel job on Saturday and Sunday....it was nice to be "home". I worked with my friends on Saturday and floated to Med surg on Sunday...hey if they want to pay me tele wages to work med surg I'm ok with that. They have Cerner Millenium computer charting...gonna take some time to get the flow of it. But, at least I feel comfortable with the hospital and the type of patients. I went to John C.Lincoln North Mountain on Friday with the agency. Very nice and well organized...it was PCU so I only had 3 patients with an aide. They have paper charting so that was easy but they use something called a med station instead of the pyxis...it was ok. Sometime I amaze myself at what I can do...just walk in and start working. They are using the new Alaris IV pump, I had done an inservice on it about a year ago but had never had hands on. I went in and figured it out without asking anyone. It was a good feeling for this old dog. Just like the medication/ drip test I had to take my first day of orientation here. I thought since I had tested at my agency that I wouldn't have to take any tests at Good Sam. Plus my friend that is here and working at a different Banner Facility didn't have to take any additional tests when she started, so I thought I was in the clear. Nope...I had to take it...and it was all figuring mcg/kg/min or how many mcg the patient was getting given the ml/hr. I freaked...I don't do that on a daily basis. Plus, I have my cheat sheets. I couldn't get it for about 10 minutes I sit there sweating..then i just started at the top and did it. I probably did it the really really long way but, I did it and I passed. I was so proud of myself. Little things that make your day huh?

Remember non noc nocere.

The Valley of the Sun

2007-09-23T13:01:00.000-07:00

We decided to try the kitchen tile ourselves. I thought it might take 2 days, it took 2 days to prep and start and 2 more for my poor husband to finish alone. I spent 4 out of the 5 days in Columbus helping my husband at the house...I really enjoyed it. So much different than being a nurse. Just as physically demanding but not as emotionally draining. I'd love to do it full time.
How do you like the yellow? Different,huh? I thought it appropriate since I am now in the valley of the sun. It has been beautiful here in Phoenix, alright ,it rained a little, but, it's so much better than the east coast. I just love the views of the mountains. I also love watching the airplanes, they tend to stack up in the sky over the city...at night especially it's a cool sight. Some of my favorite times here have been spent watching the airplanes.

I have passed all my tests and start my orientation tomorrow. It seems I have 4 days of orientation scheduled for the hospital and probably 2 on the unit...they converted to paperless charting since I was here last. So, that's the reason for the extensive orientation.

I was able to get some work from the agency ,CNS, that I signed up with. Granted it was 30 miles away,but it was work. A newer hospital and the unit had just been remodeled , it was really busy and I got little to no orientation. I made it through though...did my 12 hours and drove the 45 min home.

Still debating about a car. My husband is supposed to join me out here in the next 3-4 weeks...I really don't want to own a vehicle and have another bill but renting a car is pretty darn expensive. Still trying to figure that one out.

The house is coming along...just taking longer than we thought.Keep the good thoughts coming.

Remember first do no harm.

6 days but who's counting

2007-09-06T04:05:00.000-07:00

The bathroom is almost complete...as you can see we have a floor and a new bathtub and some paint. I will be helping to floor the kitchen when I get to Columbus...yep, I'll still be working.

Oh, it must be similar to being released from prison. This is a great feeling...I am almost out of this place. After 3 months I am really tired of my little studio apartment. I am sick of the drive to the hospital. I am REALLY tired of having to do everything myself and alone. The old phrase you don't know what you've got till it's gone is so true. I actually feel very lucky and grateful for the opportunities I have. Not many people get to do what I do. There are thousands of people out there who are only existing and surviving. They get up everyday and go to the same job for the same pay in the same car in the same town. They work with the same people and come home to the same house. I'm sure it's comfortable, I think it would drive me nuts.

I remember when my husband and I first started out on this adventure 6 years ago. As soon as we decided we were going to do it, my perspective changed. I began to look at things differently. I distinctly remember walking into work one morning and I got the overwhelming feeling I was a rat in a maze, taking the same path as everyone else looking for the cheese. It was creepy. I felt that way until I left that job.

I got the opportunity to go back to that job and work as a traveler a couple of years later. I got to see that most of the same people were still there only bigger and older. No one really looked happy and there was a lot of complaining. It was good to go home though. I enjoyed going to work and knowing the doctors and the protocols. I still had the respect of my boss, my coworkers and the doctors..there was no proving myself. But, along with that came the added responsibilities that our superiors put on us. I miss the people, not the job.

It will be the same here when I leave, I will miss the people I work with, not the job. This was a tough assignment. The culture, the socioeconomic level of the patients really stood out. Again, sad, but it opens my eyes to the truth of what is out there that most people don't get to see, or choose not to see. If you are poor and don't go to the doctor and get your check ups you can die the first time you come into the hospital. If you send your loved one to nursing home and don't check on their care they can die a slow agonizing death. Most of the doctors here cannot effectively talk to families and patients about a DNR, a lot of that is cultural, and it's very sad. There is a lot of suffering here.

Our little hospital has had 6 deaths in 2 weeks...that's a lot. Even the chaplain looks a little depressed. But, these people are so sick by the time they hit the ER, there is little chance for them.

The people who work at this hospital are a great group. They laugh a lot and get along with each other pretty well. It's hard to believe 90 % of the staff is LPN's. They know their stuff,though.

I will be losing my internet tomorrow until the 17th when I pick up again in Phoenix. Ya'll be safe. As they say here at Richmond Community...Holla at a sista whe you see her on the street, ya hear? Alright sugar.

Remember first do no harm.

2 more weeks and counting

2007-08-31T17:49:00.000-07:00

I don't have the updated pictures of the bathroom yet, because my poor husband has been too busy to get them out of his camera and email them to me. He did send this picture over my phone (I love technology) to me while I was at work the other day. We have some landscaping finally...the tree root was actually dug out later the same day but I didn't get an updated pic. The bathroom is ready for paint and the flooring will go in Tuesday morning. The furnace and central air will be in tomorrow. Things are coming together. The guy who is going to put down the floor in the bath might also do the kitchen. He owns/manages about 25 rental properties himself and he might have a renter for our place already. I will be so happy. Only one mortgage payment and to have it done and rented would be awesome!
Yeah, I'm working my butt off. They aren't letting me slack off at all these last couple of weeks either. It's been busier than ever. I have missed lunch a couple of times this week and left after 8pm yesterday. Tomorrow is day #5 this week...then I get a day off...woohoo. I have to spend it doing laundry because I have no more white uniforms that are clean. They get me in whatever I can find tomorrow... These patients are really sick. They are so poor and don't get any health care whatsoever. The ER is their primary source of health care. Lots of them have never been to the doctor and they are in their 70's. This week was also drama queen week. My goodness these women can carry on. We had this one "diva" who was yelling and throwing things. She was calling out to every doctor who got off the elevator...Are you my doctor?...they all answered no..but really thought I hope not. She would ring for the nurse every 10 or 15 minutes, literally. Then all she would say is I want to see my nurse. Of course the nurse she had was very shy and timid...it was sad to watch really. Even the nurse manager and the acting DON couldn't handle her. It's amazing this clientele here. They get away with so much that anywhere else they wouldn't put up with. Guess that's why I can't wait to go back to civilization.
I got my apartment and my cable and my plane ticket...I'm ready to go. I wish I could drive out to Phoenix with my husband, I'd love to stop in Oklahoma and see my family..but, he will have to drive out with the dog on his own. The house won't be ready in 12 days.And he has to stay to finish up. At least my traveler friends will be there...they arrive on the 7th or 8th. I'm being daring. My flight is the morning of the 17th and I have to be at the hospital for my physical at 1300, my plane lands at 1030. I hope there are no delays. I have gotten set up with an agency to work for the first week and I told them I would give them at least one 12hr shift a week for the next 13weeks. The recruiter sounds pretty new. So new in fact that he was flirting with me over the phone after he saw my drivers license picture...not very professional. But, if he can get me work I'll be happy. Wish me luck...non noc nocere.

Rain...

2007-08-21T17:32:00.000-07:00

The bathroom is coming together...I wish I was there to help...I would much rather do that than work overtime here. But, that is my lot in life. I worked 6 days last week and back to 3 this week, cuz I get to go and see my house (oh yeah and my husband...lol). It will be a 5 day trip...a good reward for my hard work.
Work has been busy as always. A couple of codes last week and hopefully I'll get out without one this week. You know it's not gonna be good when they call a code and everyone just looks around at everyone else...instead of heading for where the code is. Needless to say, they didn't turn out too well, but it got me thinking about my ACLS again. Which, is really good because I'll have to take a test when I get to Phoenix. Yeah, not only a rhythm and med test but a physical test too. it caught me off guard last time, but not this time, I'm gonna be ready. I have to do the dreaded 3 minute step test...do you all remember that from what High school? Yeah, last time I almost passed out, not this time...yes I am actually practicing. It's pretty good cardio.
Amazingly there is one patient who has been at the hospital since I got here...about 3 weeks shy of 3 months...and there's no plan for her to go anywhere. It's weird, but, it's not the first time I have encountered this. Some hospitals just can't get rid of their worst patients, they are always the sickest, and I always seem to have to take care of them ...a lot. Maybe it's because the regular staff is just in need of a rest from them...but, I need a rest too. You hear a lot of people talk under their breath..she makes the big bucks, let her take care of them. That's what I hear most often...the funny thing is I don't tell anyone what I make, it's just their guess. It's funny they don't think about the down side of traveling. You are away from all your friends and loved ones. You don't have your stuff, only a small portion of it. You can be cancelled, heck your contract can be cancelled and then where are you left? The company might be able to find you a new contract unless they are the ones who cancelled you. Then you only have 48hr to move out of your apartment, how many people do you know who could move out in 48hr? There are some down sides...I wish I didn't have to ad getting the rotten patients and the first admission and the extra patient but, I do. It happens. But, I'll take it all knowing I get to leave in 3 months and hope the next place is better.
This time I know it will be...any weather out west beats this east coast stuff!!
I'll let ya know how my trip is and I'll take lots of pictures. As they say down here in good old Richmond Community Hospital...Holla at a sista....and remember first do no harm.

This week in Richmond Virginia

2007-08-18T17:27:00.000-07:00

Just a few shots of the progress....

Hey all, it's been really hot here. And really busy. the heat is keeping the hospital full. I have been able to get in some overtime...5 tweleves last week and 6 this week. I am TIRED. I couldn't do them all in a row...I had 3 on and one off then 4 on and one off...I will be getting 5 in a row off this coming week. Headed back to Columbus to check out the remodel. Then I will have just 2 weeks left here in Virginia...then it's off to Phoenix. I already have my job and apartment and utilities lined up...that's the way it should be. I don't know why some of the companies make it so difficult.

My new traveler friend that is here is pretty miserable and home sick...I told her to tell her recruiter how she feels. And gave her some advise about ending her contract early. I have done it,only 2 times and it was on the last few days or last 2 weeks of the contract. Each one I was paying for housing so, the company didn't ask for a dime back. You have to check the fine print on the contract though. Every company is different. I wouldn't make a habit of it, although I have met travelers who have and still manage to find jobs. But, if you are really miserable or fear for your license, you can leave, the company can't stop you from leaving.

Husband of a nurse

2007-08-10T17:47:00.000-07:00

Got this in an email....it is so good I had to share enjoy and pass it on......

Written by a husband of a nurse....... Ah, such mysterious, wondrous creatures are nurses. What treasures lurk beneath those crisp, white uniforms....What young man doesn't have fantasies of discovering those secrets for himself? SCREEEEEECH!!!!!!!!!!!!! Reality check! I've been married to a nurse for a quarter of a century, and let me tell you, nurses are not what you expect (and I don't even care what you expect, because you are wrong!).
Let's begin by tearing down some of the more famous assumptions about nurses right off the top: The Nurse as Sex Kitten: Any man who lived through the early seventies or has made it a point to rent such famous videos as "Night Duty Nurses" or "Student Nurses" or "Night Duty Student Nurses" or any one of several dozen nurse-centric skin flicks will immediately believe that all nurses have heaving bosoms, just millimetres away from popping out of skin tight white uniforms. You will also believe that nurses always wear white garters, fish-net hose, and stilettos. This, of course, is a handy dress code because movie nurses spend *a lot* of time hopping in and out of patient's beds. The reality is that most nurses wear scrubs - shapeless, draping hunks of cotton that could cause you to breeze past Pamela Anderson without a second look. Shoes are white and chunky with blobs of things on them better left unexplored. Socks replace white hose and garters, and when is the last time anyone saw a nursing cap? Graduation, perhaps?
The Nurse as an Angel: If you want to hear the latest gross jokes, just find a nurse. Some uninformed males seem to think of nurses as angelic creatures: demure and loving, a cross between a nun and their mom. Well, hate to bust your bubble, guy, but as a group, nurses are some of the rawest folks you'll ever run into. I don't care how sweet and demure they may look on the outside inside is someone who has seen things that would gag a maggot, break your heart, or drive a normal person nuts. So most nurses develop a very wicked sense of humour squarely lodged in the black-to-sick side of the scale. Also, in case you are looking for angelic sympathy for the little boo-boo you had in the shop, forget it! Let's say as a typical male klutz, you manage to saw your finger off. You go running to your nurse wife who is on the phone with a nurse friend of hers. As she continues to talk to her friend, she gives the stub a good eyeballing, slaps a towel on it, takes out a baggie to put the severed digit in, and tells you to get some ice while she is explaining to her friend that her dummy husband just sawed his finger off. As you stand there bleeding profusely for 15 minutes she calmly finishes her conversation as though nothing is going on until finally she says, "well I guess I better get him to the hospital."She hangs up the phone, looks at you, sighs and calmly says, "let's go." You have just learned an important lesson. On the nurse scale of emergencies, yours is about a minus 9! As my wife has told me, "when you are on a ventilator, with six drips running, your head down and your feet up, then you're sick. Anything less than that isn't worth getting excited over!"
The Nurses Mutual Benefit Network: As a male either dating or married to a nurse, you should realize one important thing. There are nurses everywhere. That, in itself, is no big deal. The fact is, every nurse knows other nurses who know more nurses, so that by the time you are finished, a nurse on the Island Nation of Chuuk who observes you doing something you shouldn't has the immediate capability of getting word to your wife. This system is way more reliable and efficient than the Internet and has existed for a much longer time. Take it for granted that your nurse wife will know about anything you have done, good or bad, before you get home! Your Social Life with Nurses: Nurses hang out with other nurses and soon you may find that all your friends are married to nurses. The reason this happens is because in situations where nurses mingle with nonmedical folks things can get ugly. For example, you are out to dinner with your nurse wife, another nurse couple, and two civilian couples. The nurses sit and chat, discussing fun things like bleeding bowels, open sores, how much fat was sucked out of some patient, projectile vomiting, traumatic amputations, etc., all over a nice pasta dinner. The nurses carry on talking as the civilian couples turn funny colours, make faces and suppress their gag reflexes (and this is if the nurses don't have any really gross things to share like the homeless guy with maggots in his bleeding sores!) After several dinners and gatherings like this, you will soon find your circle of friends has shrunk significantly. The key to avoiding this is to do the following: Never go out in mixed groups with more than one nurse. A lone nurse is ok. The trouble starts when you have more than one, and when that happens, keep the regular folks away. Also get used to the idea that some friends and neighbours will take advantage of the fact that your wife is a nurse by calling at all hours of the day and night for advice. This may include male friends "dropping by" to show your sweetie his rash. The best advice I can give is to just deal with it and hope it isn't contagious.
The Health Ramifications of being with a Nurse: Most nurses have been described as having the constitution of horses which isn't true because I've been around horses and they get sick more often. The reason for this is pretty simple. After about 3-5 years on the job, nurses have been exposed to so many bugs that they either end up dead or full of every antibody known to mankind. (If you want the ultimate booster shot, just get a blood transfusion from a nurse who's worked in a hospital for 20 years!) You don't have all these antibodies, though, so when she does come home with mild sniffles, a week later you're flat on your back with the worse case of the flu of your life!! Oh, and if you are the least bit squeamish, don't even think about the bugs she brings home on her clothes. It will mess with your mind as she talks about her resistant TB patient, the patient full of body lice, or the one with poison ivy in his mouth! so don't ask. Conclusion: Ah such mysterious, wondrous creatures are nurses

Hot and Humid

2007-08-08T06:42:00.000-07:00

What is with this heat? Wow, the humidity here is just stifling. The kind where you walk outside and can't catch your breath. Good thing the hospital is letting me work some overtime...I get to use their air conditioning instead of mine...lol. This week has been brutal so far, 6 and 7 patients, no charge nurse and only 1 or 2 techs for 25 to 30 patients. The acuity is really high as well...then on my worst day ever they messed up staffing and a nurse who they thought was supposed to be there, didn't show. I didn't get to leave until 8:45. I had no words to describe it...I had a horrible day then my relief doesn't show...They are still using agency per diem nurses because their own staff is burned out, but they are not using as many. I have 5 shifts this week and next...if they allow me to work them all. I know Uncle Sam will be happy if they do.
Work is progressing slowly at our rehab because of the heat. Heating and A/C will be the first thing to be completed. I think we might be one of the only houses on the street to put in central air. Hopefully it will be a big help when it comes to renting the place.
I have begun the hunt for my next assignment to Phoenix. I called a couple of companies but I think I will go with the one I worked with last time. They have the best hourly rate and make the process so simple. I think this assignment has burned me out on trying new places for a little while. I also have had enough of nursing on this side of the Mississippi. Not that I can't handle a patient load of 6 or 7 or more but, I don't want to when I know I don't have to. All the hospitals talk about 5 star service and patient satisfaction, blah blah blah...how is it possible when you have 6 or 7 patients? What about nurse satisfaction? No one talks about that.
Remember first do no harm.

Rehab #1

2007-08-04T07:19:00.001-07:00

Well, as you can tell, I have been a little busy. For instance, last weekend I worked Friday, Saturday and Sunday. Got on a plane Monday, which was delayed and forced me to miss my connecting flight in Cleveland. Luckily my husband loves to drive and made it to Cleveland shortly after I landed. Then we drove the 2 hours back to Columbus to the mortgage guys office to sign some papers. Then we went and visited my Uncle, the one who had surgery for his stomach cancer...he is doing very well. Then back to my brothers house to visit and sleep. The next morning we got up early because the sheriff was supposed to come and remove the renters from the house next to our rehab...but, it didn't happen. Columbus has a lot of foreclosures and the sheriff's office is overwhelmed. From there we went to our closing...only about a half hour or 45 minutes of signing papers. It's really hard to sign your name the same that many times in a row. Then we had some lunch and went to the new house...we cleaned a little put up a new porch light and changed the door locks. I'm so lucky to have a brother with skills...the door lock we bought didn't fit the hole that was made so, he went to his truck and got out his jig and drill and made it fit. Of course he had to use his half inch drill and of course it caught a couple of times and tried to rip his arm off. What fun would it be if it didn't? The my husband and nephew pulled down the awful wall paper..it's so old it came off in sheets...only thing left on the wall was some old glue. Then we got up the next morning and drove back to Virginia so I could go to work the next day. A little hectic but, oh so much fun....I'm so happy to be doing this rehab. Ok, I won't get to "do" most of it, but I will be seeing the work in progress via the internet.
Work has been interesting. There's a new sheriff in town...no just kidding ...they have an interim administrator who has decided to make some changes. No more per diems, we now daily have 6 or 7 patients, with 2 techs for 30 patients. They decided not to cancel the travel contracts...I don't know how I feel about that, I wouldn't have minded leaving but now they are giving me some extra shifts since the agency people are gone. It's not a pretty time. There's a lot of complaining and the nurses who were already pretty burned out are talking about leaving. I don't see this hospital staying open much longer...although no one else in the city wants the patients who come here, so, the other hospitals may keep it open for that reason. I'm just glad, once again, to be able to walk away from a bad situation before it gets worse. I try to be as positive as always knowing I don't have to stay and deal with the stupid changes that administrators make. It really makes me appreciate the good hospitals I have been in. That's why I do what I do. I will be updating you all on our progress and the hunt for a new job as well.September is just around the corner...thank goodness.
Remember first do no harm.

Only in the south

2007-07-18T18:30:00.000-07:00

I was at work the other day, looking at the cafeteria menu, and I thought wow, I don't remember seeing these things on any cafeteria menu before. Things like grilled cheese with tomatoes and bacon, turnip greens, collard greens,and kale. Also lots of smothered stuff and meat with gravy. Of course no breakfast is complete without sausage gravy on biscuits, corned beef hash and baked apples...baked apples, that was a new on on me. Makes me think they are trying to get the staff to become patients with their heart unhealthy diet.
I met a new traveler the other day. I heard from my recruiter that she was coming, she's working night shift. She is living here at the apartment complex I discovered. I think she would have left if she had gone to the hotel they were offering us. It used to be something else and now it's a suburban extended stay...pretty old and dated and no pets allowed. She's really young and it's her first travel assignment. That's what I hate about these travel companies...they don't consider the whole picture. I don't think you should send a young white girl from a small town to an inner city hospital. She was scared to death when she drove up on the hospital...the projects are right down the street. A lot of houses surrounding the hospital are boarded up. She was outside the other night with some other nurses having a smoke, heard what she thought were firecrackers going off...the other nurses put out their smokes and told her to get inside that she was hearing gun fire not firecrackers. Things like that will make her think twice about traveling again. It's a good thing the nurses and other hospital personnel are so nice or she probably would have left by now. Just amazes me how little thought most recruiters put into assigning nurses. This hospital is for experienced travelers who have seen this part of the world before, she needed a little more mellow hospital to start, not the middle of the inner city. Maybe on her next assignment or the one after that this place would have been ok. I'm sure her Mom was not happy about leaving her here after she saw the hospital either. Just glad we found a nice quiet place to live.
Hope all is well in your world....remember first do no harm.

Agency nursing

2007-07-10T08:19:00.000-07:00

I am so irritated. Sometimes this agency travel thing just gets to me. I still think it's better than a staff position in the long run but, it can be so irritating. First, this travel agency I am working for seems to be staying true to their word. Just remember to read every line of your contract and you should probably either read it and put it down for a while and pick it back up with fresh eyes or have someone else read it as well. My contract is actually for 14 weeks... I called my recruiter to see if it was a mistake, she said no, it's to help you get all your hours in because sometimes you don't get them all the first week. Well, I did, can I leave a week early? Probably not...so much for this stupid company. They all have their little things, they are all a little different, not always in a good way.
Next, I signed up with Nurse Finders when I got here. I told them where my contract was and they said no problem they had plenty of work for me. I have worked with them one day. It turns out, all the shifts they have are at the hospital I am contracted at and I can't work there for 2 companies. They put me at an adolescent psych facility which is so not where I am qualified to work. Today they called me to work there. I told them fine but I am not going to do a med pass, if that's what they need then I am not going. I don't know if y'all know what a med pass at a psych facility is but let me try to explain. You are locked in a little room with your med book. You have a tray that you put all your cups in and fill them with the meds. So, the checking the name band as a second check and asking their birthday, or even telling them what they are taking is out the window. There is a picture of each person that you put by their cup so you know who to give the pills to. Then you either open a little drive thru type window or open a half of a door and then your announce that it's medication time. They all file up to the door for their pills. Now, they aren't patient, they don't care if it's your first time, in fact, they will mess with you and tell you they are someone else and not take their pills or spit them out just to mess with ya. Also, if one of them goes off and needs a shot or some extra meds, it's the med nurse who administers it. Not to mention the fact that all the doors are locked and you have to watch who is behind you because they will try to escape. So, the agency was not happy with me and won't put me at that facility because I won't put myself in that position. I tried to call and talk with the office manager to explain that maybe they don't understand my position and that I was irritated that they had said they had plenty of work and it turns out that they don't. They said it was my unwillingness to go where they had shifts...I told them I guess I need to find work elsewhere. I am not willing to risk my license for a couple extra bucks.Why didn't they just tell me they couldn't help me when I went there...before they bothered my references, and I spend my time and money to drive to their office and take their tests. It is very aggravating and it seems to happen a lot. It has happened in every city that I have tried to get work except Oklahoma City and Phoenix.
Ok, I'm done, I feel a little better. Just be sure to check the fine print and don't be afraid to ask questions. Remember, the agencies are working for you, you are making them money and don't let them tell you what you can do. Know your limits and stick to what you are comfortable with because they probably won't stand behind you if you get stuck. They are in this purely to make money, we are here to help people and secondly make money. Remember first do no harm.

Life goes on

2007-07-02T19:02:00.001-07:00

Hi everyone. I am still here in good old Richmond. The picture above was taken on Virginia Beach last week. The weather was not very good, by the time we got to the state beach, which is the only place we could take our dog, the weather had broken and started to clear up. It was about a 2 hour drive and the state beach was nice. Virginia beach was very commercialized, lots of big hotels and a boardwalk. We were going to try tandem bicycles but the weather kind of killed that idea. A wet butt on a cool beach didn't sound very romantic.

My time at the hospital has keep me sane while I am alone here.My husband went back to Columbus on Sunday last week. The clients are mostly poor or the poor from the nursing homes in the area. A lot of them are in pretty poor shape (otherwise known as a hot mess) and no family or anyone to claim them. It makes code status a difficult subject. It's also hard to decide what all should be done or that really needs to be done...luckily I don't have to make those decisions. I care for all my patients the same. I got a compliment from one of the doctors today on how good my patient looked. She had just been admitted from the ER about 2 hours before. With the assistance of my PCT ,I was able to give her good mouth care and clean and lotion her dry skin. My PCT has taught me just the right combination of things to use on their skin to make them less dry. I also passed on the compliment to my boss and the PCT...give credit where credit is due. I listen to my PCT's and LPN's, especially if they have been there awhile, they know the place and the people better than I do. I know my nursing, a lot of times they know the ins and outs of the hospital and can keep me out of trouble. Not so much trouble I guess as keeping my foot out of my mouth.

I am trying to pick up more shifts but the census is pretty low this holiday week. It's really messing me up having a holidayin the middle of the week. This particular hospital doesn't recognize the 4th as a holiday. They only pay time and a half for Thanksgiving and Christmas...kinda weird.

I pray for a quite time for all you ER nurses, but I know the holiday will bring some interesting times for y'all. Keep the peace and first do no harm.

Working in VA

2007-06-20T06:32:00.000-07:00

It's been about a week now, I can officially say I have survived. I got my car from Enterprise, after a couple of changes I got one that wasn't so used. Only 10,000 miles and it still smells pretty new. I went to Nursefinders and had my first shift yesterday. I branched out to psych, which I have done only a little bit of. It doesn't scare me just makes me sad. I went to a boys inpatient center in the next town, about 30 miles each way. The staff was very helpful and friendly, although I didn't get much of an orientation they helped me through it. I think I'll go back for the extra cash. Still no luck picking up extra time at the hospital where I am.
Today we are going to the coast. It's a little gray out but, maybe it will be nice on the coast. I'll try to get some good pictures for y'all. Remember first do no harm.

Virgina

2007-06-10T18:05:00.000-07:00

So, there's nothing I like more than to get into a city on the wrong side. It was quite a sight, not to mention the 98 degrees and 80% humidity. The company I decided to go with this time does not get housing for you but will put up the security deposits and make the monthly payment out of your check. They offered one suggestion, an off brand of the extended stay...not so nice. Especially not for $950/month. So, we have spent the last few days on Craig's list and looking through the apartment guide. It's really quite frustrating, I know I should look at it like an adventure...but after the first 2 days it's pretty hard. I did look into rooming with other people as well but, that didn't work out so well. It's amazing how some people live.
Luckily, we found a furnished studio which is really cute for one person who is going to be working all the time and not entertaining at all. The apartment itself is tiny 228 sq.feet but it's a one story place so no loud upstairs footsteps and it's very quiet.
I had my first day at work yesterday. It's a really friendly place, the staff is nice and the patients are cooperative and mostly grateful for what you do. The big plus is not having to use my Spanish at all. The hospital is in a really rough part of town but, my apartment is not. We went to Enterprise today to get my car. I got what was left for the week and will be going back tomorrow to get a better one. This one is well used and I don't really want to drive it for the next 3 months. Luckily, they were also very nice and it won't be a problem to get another car.
So, things look pretty good here in Virginia so far. Hopefully the pay check will match. That's the bottom line here for me this time around. Will let you know if anything fun happens.Remember first do no harm.

Holidays

2007-05-27T17:45:00.000-07:00

I will miss seeing all the scarlet and gray when I leave here. Maybe I'll be back for football season...probably not though. The work here is just not worth it. I work twice as hard here as in the west for half the cash. The gray also describes the sky most days. I still don't know why people stay here all their lives...the weather really pretty much stinks.
So, the holiday is Monday, but, if you work night shift, the holiday is Sunday night. This hospital pays all 12 hours of holiday pay on Sunday. Guess who doesn't get to work in Sunday? The travelers. But, we're scheduled Friday and Saturday, Monday and Tuesday...pretty slick. If it was Christmas or New Years you can bet we would have been scheduled. Just a little irritating, makes me want to call off on Monday night.
The morale is just so awful on the unit it can be so draining. All night hearing nothing but complaints being thrown freely about the floor. You would think they would complain to someone who could change things, like their boss. But, instead they just complain about her. Just one more reason not to become staff, it's too easy to get caught up in the complaining and I just don't want to go there.
I am still waiting to hear from a hospital in California for an interview. The company I was with in Arizona will take me back, but, I have to come down a week early to get another physical (which was done in August of last year) and take a couple of tests. At this point, I am not willing to give up a week of pay to do that. I think it's totally ridiculous since I was there less than 3 months ago. I suppose I could go back to the same hospital with a different company but the pay would be $4 less an hour. It's a toss up...maybe I'll just wait till it's cooler there like I originally planned. I will be missing my friends though, hopefully they won't mind too much and we can pick right up where we left off. I will probably end up going there alone as well so, it could be a totally different experience. My husband will most likely be staying behind here in Columbus to further a new business we started. We've done it before, it's not fun, but you have to be willing to do what it takes to get the end result you want.I would just like to work a little less hard for my money, ya know?
Hope you all have a great holiday or at least got some good holiday pay. Remember first do no harm.

A change of pace

2007-05-22T11:55:00.001-07:00

Well sports fans...this is one of the things I will miss when I leave Ohio. I am a huge Cleveland sports fan, sad but true. I love the Indians and the Browns. I love to watch Ohio State football as well. I think I got it from my mother. Funny thing is I married a guy who doesn't know sports. He could care less if it's football season or baseball season. He does, however, care about keeping me happy...which is most important...cuz we all know if the wife ain't happy...ain't nobody happy. So, Saturday night at work he text messaged me with a picture of an Indians ticket and asked me if I wanted to go. It helped me get through the night I tell ya. Sunday was a little rough, trying to sleep in the truck while he drove the 2 1/2 hours to Cleveland. It was typical Cleveland weather, gray and cool and a little damp but, I didn't care. Our seats were pretty good for being free. Oh, yeah, he got them off of Craig's list for free. My sister and her boyfriend go to all the games, he has season tickets, so we went to see them after the 7th inning stretch. That's were we got the first picture...just an awesome view. Plus, the Indians won!!! It was a great day.

Now we are in the hunt for a new job. I am not thrilled with my company, or my recruiter, so we are searching elsewhere. One company I am trying is called Nurse choice..check out their website..www.nursechoice.com. It gives you the pay rate right on the first page. I have been submitted to Tucson AZ, St.Mary's hospital. Almost all the hospitals in AZ belong to an association who decides the pay for the state it's 28 or 30/hr. This particular hospital doesn't belong to the association so they can pay more, which is the only reason I would consider heading back to the desert in June and July. Ok, maybe it's not the only reason, I do miss my friends..you know who you are. And it's not far to drive to Phoenix to see them.

I am considering a couple of other companies, we'll see what they come up with. I don't enjoy the hunt. It's like looking for a new car. You know what you want and the money you want but no one seems to have the exact thing so, you have to pick from what they have to offer. It can be frustrating. And, the closer you get to the time you want to leave, the more frustrating it gets. Will keep you updated.

Remember first do no harm.

Questions

2007-05-14T08:51:00.000-07:00

Ok folks there are these things running around the blog world called MEME's. Basically someone asks you five questions and you answer them. kinda like a get to know you type thing. My questions come from a blogging friend Jleonard at Adventures in nursing. So,here we go with the questions:
1. Being a female, what are the top five pick up lines used on you? And did they work?
Uh, pick up lines, I'm trying to remember. Pick up lines.... I got nothin. Are you looking for some new ones? lol.

2.You are to be sent to a deserted island. You can not take a cell phone. What do you take and why?
No cell phone, no recruiters calling me while I'm trying to sleep!!! How long am I staying on the island? I need more information. I probably would take a box of lighters and matches (I assume it gets cold at night and I hate to be cold), sun tan lotion (I don't like to burn), a new bikini (with little food it will be a great time to diet and I'll be looking hot in no time),that stuff that purifies water (assuming it's salt water), a knife, and a tent (to keep out the bugs, I don't like them either). There's a lot more I could bring, but, I assume I'd have to carry it all, so I can live with that.

3.Your luggage is lost at the airport. What would you miss most?
Being a traveler, I am used to replacing my stuff when I forget it or lose it... if it's the luggage from question #2 I am pissed!!! I need all that stuff!

4. Where would you like to retire to and why?
It's funny people usually ask when I am going to stop traveling and where I want to live...but I want to retire to the Rocky mountains. Some place like Estes Park Colorado, absolutely beautiful scenery, and peaceful.

5.You are a tape worm in a celebrities small intestine. Who is it and why?
Ok, I just want to say gross. I would have to pick Mario Batale the chef...have you seen him? He eats whatever he wants and he's a chef so it's all the best food.

So, who's next for the interrogation?

You too can get in on the fun of the FIVE QUESTIONS., Here are the Interview Meme rules:1. Leave me a comment saying, “Interview me.”2. I will respond by emailing you five questions. I get to pick the questions.3. You will update your blog with the answers to the questions.4. You will include this explanation and an offer to interview someone else in the same post.5. When others comment asking to be interviewed, you will ask them five questions.

Nurses week gifts

2007-05-09T10:17:00.000-07:00

Tell me what things your company or hospital has done for you for nurses week. My current travel company sent me a plastic light that attaches to the bell of my stethoscope. I am unsure of the purpose, I don't remember finding a heart beat with a light before...maybe I'll give it a try (lol). I think it might be for checking pupils, perhaps they are encouraging me to multitask and check them as I am headed to the chest to check the heart beat all in one sweeping motion. Can you picture it? Maybe it would work if the patient would hold their eyes open with their fingers for you... aahhhh, that's funny.
Oh, and I got another one of those stretchy thingys to hang my badge from. They always seems to turn my name and my face around. No matter how many times I turn it so my face can be seen, someone is always asking my name and when I look down to see if maybe they can't read,I see that my badge has once again turned around to face me. Maybe it's trying to rub off that awful picture I took, nah, couldn't be just a design flaw I'm sure.
So, my last day at work was much better. I still got an admission but, only one. Last week when I worked I didn't think I would make it through the shift. My night started out with one patient asking for pain meds, one alzheimers patient, and one with a heart rate of 170. I asked the nurse who had given me report how long the patients heart rate had been high, she said she couldn't remember but they had been telling her that it was high. She said she was just really busy. At least she called the doctor before she left. I went and told the charge nurse, so maybe she could come and help me, but she just said oh,ok. So, I gave the cardizem bolus, the charge nurse looked at me crazy when I asked her to keep an eye on the monitor for me while I was giving it. Reluctantly she turned the monitor on at the nurses station and sat back down. Then it was every 3 hours dilaudid for one patient with zofran in between. She was going for surgery in the morning so I had the check list to do and she was going to have an insulin gtt after midnight as well. So, there's two drips. I have an alzheimers patient who's lungs sound awful. I got her a breathing treatment, then the GI doc comes in and says she needs Mag citrate so she can get a PEG in the morning. I was a little confused, but, she couldn't drink it...dysphagia, so I had to put down an NG. Plus I had 3 other patients, luckily they were pretty stable. I mentioned to the charge nurse that I was having a hard time and she said oh I know isn't it busy? And walked away. Finally, at midnight ,when I was just about to lose it completely, she appeared and said she had come to help me and ,by the way, she was giving me an admission. Yeah, it was a fun night. Then last time I worked I got called into the asst mgrs office because the charge nurse from the other night had written me up. She wrote me up for giving iv dilaudid that was ordered for my patient because we are supposed to try p.o. first. The patient had refused the p.o. but I didn't chart it, apparently it warrants charting at this facility. I said the nurse before me told me she had tried p.o. but the patient had refused but, I guess we have to chart that they refused every shift...what a pain in the butt...that's the stuff that makes me hate nursing...it slows me down.

Nothing else for nurses week, just a card from my sister the nurse. She always remembers to send a card. Hope yours was a good one.

Remember first do no harm

Happy Nurses Week

2007-05-02T13:19:00.000-07:00

Thought you all might get a kick out of this picture. We often talk about the Jesus bus coming to get our patients, but how often do we actually see it? I hope when mine comes it's in a little better shape! I thought I would write about the good parts of nursing and leave the dark side for a while.
Nursing has been a great career. I have been able to travel to some really awesome places. I've ridden a horse in Rocky Mountain National Park. I've stayed in a little cabin by a river in Estes Park Colorado. I've picked shells off the beach in Maine at sunrise which was breathtaking. I've driven on Daytona Beach and seen all the bikers during Bike week. I've para sailed over a beautiful Florida lake. I've seen cactus wrapped in Christmas lights. I've watched sea lions play in the Pacific. I've watched hot air balloons hover over the hospital in Napa. And I've watched the full circle season of the grape vines, from dry looking twigs to lush green to harvest.
I have met some of the best people. I wish I had the space to name each one. So many have made the extra effort to make me feel at home in their cities and hospitals. I wish I could put all my favorite nurses to work with together on one unit, then I might actually take another staff position. All of my friends from Hillcrest Hospital in Mayfield Hts Ohio, Florida Hospital Orlando,Mercy Southwest in Bakersfield,Good Samaritan in Phoenix and The Queen of the Valley in Napa. I am especially glad to have met all of my traveler friends, they have given me some good tips over the years.
I have seen some interesting patients and disease processes. I never would have known about Valley Fever if I hadn't gone west of the Mississippi. I have seen patients who had robot assisted coronary bypass surgery, never thought I'd see that. I've taken care of inmates in a locked unit, never thought I'd ever do that either.
All in all ,I think without travel nursing I wouldn't be this happy. I want to thank my mother and my sister for inspiring me to become a good nurse like them. I want to tell everyone how proud I am of my niece who started out as a CVICU nurse.She is now getting her masters and is helping to run a pain clinic. She does it all, works, goes to school and has 2 beautiful children to take care of. I have no idea how she does it. Just amazing.
Lots of days, if I take them by themselves, I would tell you how much I dislike my job. The day to day stuff is hard to do, in some places more so than others. But, if you look at it over all, it's not a bad life. Thanks Florence, nursing is nothing like it was when you were alive. I wonder if she is glad when she looks down to see what it's become?
Anyway, I hope everyone of you has a great nurses week. I hope you get massages and get fed and get presents, maybe even a little extra in your check. Maybe you'll even get that rogue card in the mail from someone who remembers that it's nurses week.
Remember first do no harm.

6 weeks left

2007-04-25T16:40:00.000-07:00

So, can you tell by the title how well my new job is going? The difference from the west coast is just incredible. First the nurse patient ratio is 7 to 1. There is no one watching your telemetry monitor. This hospital (Grant) has one monitor in each of the 4 halls about half way down. At the end of each hall is a LED screen which flashes the room number and the rhythm in orange letters. Any alarms show up in red and there is a slight noise when it happens but, nothing that would really get your attention. I have to wear a pager, a locator and a cell phone. These are issued to me from a department in the basement where 4 -6 people sit and answer ALL patient call lights. Then they page whoever is assigned to that patient. I personally think the money would be better spent on tele monitor techs. All of the discharges are on the day shift so nights gets all the admissions. It's a little hard to get used to.
My first orientation night I got the scoop on the whole floor, why people are unhappy, why they are leaving, how many have left, who to watch out for. It's a great thing. The staff is unhappy, management is all new on the floor and they are very young. I don't think I will be staying past my 8 weeks unless I really have to. I just thank my stars that I know what else is out there as far as nursing jobs, so I am not stuck somewhere like this. I will be doing my one or two days of overtime a week because I need to.
My traveler friend and her husband just went from Reno to Redding CA. They are in a 2 bedroom house with a fenced in yard and loving it. She just started her job, but sounds happier than I am with the facility.
The weather is typical Ohio. Warm and sunny, then hot and muggy, then cold and gray and rainy. It's been nice being around my brother and my Aunt and Uncle. My Uncle got moved to a rehab facility for PT/OT/and speech therapy. It was a shock to both my Aunt and Uncle how these places operate. The beds are old, the equipment is old, and you have to wait a good while for your call light to be answered. I just hope he works hard and can go back home very soon.
Well, say a little prayer for me to tolerate these next few weeks. Remember first do no harm.

Passed my test

2007-04-19T16:07:00.000-07:00

OK,I miss the weather in Phoenix. This is me the week we left Phoenix...I haven't been without a jacket since. The gray skies don't help either. It has been great hanging out with my brother and seeing my Uncle and Aunt. But, I miss being able to go out anytime of day in shorts and seeing the blue sky everyday.
I passed my PBDS test. If I return here within 2 years I won't have to suffer through it again. I thought it was just us travelers that had to take it. It turns out all new staff nurses and agency nurses have to take it, only the travelers can be fired if they don't pass. Did I get a perfect score? No, I don' like tests, but I passed so I'm happy. I am still enduring the orientation process, in a classroom. If they want to pay me to sit all day, I'm there. Yeah, it's boring , and yeah I've heard most of it before, but I'll survive. Our traveler portion of the orientation class is small, was supposed to start out with 10, only 6 showed. The staff portion has 25 people and most of them are going to Grant,like me. Makes me wonder what happened down there, and why they need all of us. I spoke with my manager as well, to get my schedule. I have already been offered overtime and they haven't even met me yet...I'm a little nervous. But, it's only 8 weeks. I start my night shift Sunday...will let you know how it goes.
Remember first do no harm.

Ohio weather

2007-04-14T13:05:00.000-07:00

Just a quick entry, we have arrived in Columbus Ohio.It is cold and rainy and tomorrow it might snow. Welcome to Ohio! I am attempting to give Ohio Health another try.My orientation starts Monday for a full week...pretty amazing considering I am only giving them 8 weeks. That means staying at an Extended Stay...it will be interesting. I have just completed 3 hours of mandatory online testing prior to orientation. Monday I have the dreaded PBDS Performance Based Developmental System of testing. It's torture. Watch videos and tell what is going on with the patient and what you would do and what to tell the doctor. Ugh.Wish me luck!

Crunch time

2007-03-27T09:12:00.000-07:00

It's almost time to leave the cactus behind us. 10 more days to go. I am still in the hunt for a job, but have decided to take whatever Columbus will give me and work with an agency as well. Luckily, I am working with Intelistaf, who does both. So, if no travel contracts come up I can still work. Agency or registry work is more flexible too.

It's been a rough week. Some really difficult patients, not that they were necessarily very sick but, their personalities were difficult. I really don't like being yelled at by patients or families, luckily I was able to keep my cool and defuse the situations without making them worse. Sometimes it works in my favor, sometimes nothing works.

I will miss my coworkers the most from this assignment. Some I knew from my last trip here but, a lot of new friends. There are some outstanding nurses at Good Sam, I feel lucky to have been able to work with them. I also worked with some fantastic nurses aids and secretaries. I wish I had the time and space to name them all...but I would rather just say thank you and if you ever have the opportunity to work on Tele (the first floor or the 5th floor) it's a great atmosphere. I hope to come back in the fall once the weather gets cooler. We'll see what the rest of the year brings.

My husband and I were discussing leaving Phoenix last night on our drive home. I am so lucky to have that time to relax after work. Most people have to walk to their car and fight traffic and be alert on their commute home, I get to step out the door and into the truck, relax and pet my dog on the way home. We will miss the mountains and the scenery. On our drive to work and home we pass through a small mountain, and as you crest the hill you can see all of Phoenix. It's awesome to see all the airplanes in the sky in the evening on our way home...there's usually 6 or 7 just staged across the sky waiting to land. We will also miss the weather, last week was hot in the 90's but this week has been 70 and 80 and always a big blue sky. But I'm in the job to travel...so, will keep you posted. Remember, non noc nocere.

Still waiting

2007-03-24T19:43:00.000-07:00

Just waiting. I haven't gotten an interview yet. I have my profile in with Ohio State University hospital and Ohio Health, also with Norman Regional Hospital in Oklahoma. I am in a holding pattern, but, it's not the first time. I can always go to Columbus and work agency until I find something. It's not my first choice because I would not have the housing, but we do what we have to do when we are chasing our dreams. Who thought my dreams would take me to Columbus Ohio?
I had my orientee again this week, it was a rough day. I was back down on the surgical unit. Our thoracotomy patient who had her chest tubes pulled on Wednesday ended up getting them back in on Thursday. It was not a pretty sight. The patient has been in the hospital for almost a month. Lots of hostility and anger on the part of the husband was not making my job any easier. Then we got a transfer from the Dialysis center who was in rapid a-fib. Luckily she self converted before we had to hang the Amiodarone and start heparin. My orientee just wasn't able to keep up with the pace, the language barrier is really tough. I don't know if he is fully understanding me or the patients or the doctors.
Only 13 more days. It has been a fun ride here in Arizona, I really enjoy the hospital and my co-workers, some of them more than others. I would love to come back and work here again. The staff really tries to make you feel like part of the team, it's nice. We'll see what the future brings. Remember first do no harm.

Mistakes

2007-03-20T17:24:00.000-07:00

Can't wait for the drive...ok, I really can, but I'm ready to go. My husband has his own personal style of driving and thinks no one else know how to drive. I find it rather annoying but, at least I don't have to drive. I am really not thrilled this time because once again we have a trailer full of stuff to travel behind us. Oh, and not to mention the lovely rise in gas prices. We figure it will cost about $500.00 just in gasoline to get from Arizona to Ohio. Sounds great, huh? Not to be out done by the fact that I don't have a job yet. Ah, the joys of traveling. The above picture was taken somewhere in California, I hate to see these especially when we are pulling a trailer.

So, I had an orientee again this past weekend. He's a nice guy, not the same guy as last time. His English is not the best, and I think I might intimidate him a little. He was looking for one of the patients Med records, I accidentally handed him a different book than the one he wanted. He administered the medication and unfortunately did not follow the 5 rights. Now, don't think that I was not doing my job. This guy is on his last week or 2 of his orientation. He has a nursing license, he has been administering medication for weeks by himself. But, he gave the wrong pills to the wrong patient, he went in the room with the medication record and claims he even looked at her name band and still gave her the wrong meds. I made sure he went right back in the room to assess the patient and take her vital signs. She was fine thank goodness. It wasn't all bad, some of the meds she got were actually right. Some were the right meds but the wrong dose. I reminded him that we are all human and not machines, we do occasionally make mistakes , we just hope no one gets harmed because of it. I had him call the doctor, but, due to his poor English I spoke with the doctor and told him what had happened. Luckily, nothing untoward happened and the patient never knew. When he went back in to administer some medications she needed and hadn't received she didn't ask why she didn't get them earlier. I would have told her they were not available earlier if she had asked. I know how it sounds, like I'm lying right? No, I am preserving the nurse patient relationship. If she had known that he had made a mistake she would not have trusted him the rest of the day. Plus he felt bad enough. I guarantee he will check every name band against every medication record from now on, probably twice. I told him that the way to stay out of trouble is to admit your mistakes, follow protocol and most of all monitor your patient for untoward reactions. It's the worse feeling in the world to know you made a mistake, I try to avoid them by following protocols and safety measures put into place. I always check my patients name bands against the medication record right there in the room. I check my meds 3 times, once when I get them together , again before I go in the room and a third time as I am opening the packages and giving them to the patient. That's why I hated giving meds at the psych hospital. They don't follow any of those rules, you can't even get most of the patients to tell you their name, plus they won't wait for you to sit there and open all the packages, so, you don't get that check. So, as I always say, first do no harm.

In search of a new home

2007-03-12T11:06:00.000-07:00

Well, it's that time again. Looking for another assignment is exciting and frustrating as some of you may know. Especially when the company you are with doesn't go where you want to go. That's my current dilemma, Banner travel only goes to Banner facilities, which would be great if I wanted to go to Alaska, Wyoming, Colorado, or California...but this time I want to go to Ohio. I have a goal to put my husband to work and to spend some time with my brother and uncle. Also my friends and some more family are just a stones throw away in Cleveland, so we can see them too. It's lonely being out away from everyone you know but it can also be freeing. No family/friendship demands. Sounds selfish doesn't it? But, I can only live that way for a little while, then I need to reconnect with my peeps.
So, in choosing a new assignment, I have to come up with my priorities. Like this time, location is my priority, then money (it's always on the top of my list), then company benefits. The hard part is weeding out the people who cannot help you at all. It's a game. It's kind of like buying a new car and recruiters are kind of like car salesmen. I have searched hundreds of websites and sent out lots of emails, some return my calls, some don't. Like RN Network, as I have said before I was not going to use them again because they left me high and dry out here in Phoenix last time I was here. They forgot to extend my apartment lease a week until my contract was over and I had to pay out of pocket for a 3 night stay in a motel. But, I called them and a recruiter left me a voice mail about 2 days later. When I called her back, she said she was busy and could she call me back, I said sure, and am still waiting for her to call me. That tells me she is way too busy to help me. So, I talk with the ones who do call me back and tell them a little of my backround and what I am looking for. All of them want you to fill out their paperwork, whick on average takes about a half an hour. I am not spending my time on paperwork if they don't have a position where I want to go. Everyone says "We have new assignments coming in all the time, if you have your paperwork done we can submit you that much quicker." Ok, but it only takes a half an hour to fill it out, how much faster do I really need to be submitted?
I always ask about benefits, like free housing and what that includes, also if their medical benefits start day one of the contract, some start the first of the month after you have worked for them for 30 days...that's about 3 months by my count unless you start on the first of the month then it's only 2 months. That's about crazy to me. I work in health care...I know s@%t happens when you are not expecting it, I need health insurance. Some people go on their own and buy personal health insurance but I am not at that point.
Those are really my priorities, location money and benefits. Other people are hung up on travel money or bonuses, I'd rather have more per hour than a bonus that is going to be taxed away. Yeah I got a $1500 completion bonus and it was lumped in with my regular pay check so it threw me into another tax bracket and I saw about $700 of it. Why don't they just tell you it's a bonus of some kind and you'll be happy when the check is bigger instead of wondering where it all went?
So, right now I have my paperwork in with about 4 different companies, 2 have submitted me for positions in Columbus, one at OSU (go bucks!!!) and the other at Ohio Health which owns Grant, Riverside and Doctors hospitals. Hopefully I will get into OSU. Now I wait for a phone call from the nurse manager on the floor for an interview. Keep your finger crossed...remember first do no harm.

Alone again

2007-03-02T09:55:00.000-07:00

That's my quote for the week. My goodness, between my co workers and the patients and the patients families...it was a soap opera week. Starting with a coworker who had some drama on her early (8 am) morning break with her significant other, she called us to say she was having some trouble and would be back soon. At 930 when I went to get some coffee I saw here in the managers office with the Phoenix police. Needless to say, she did not return to work and left us short. The week before I was working with another female who is pregnant and spent the whole weekend sitting in the break room and telling me what she could not do because she was sick. I know it sounds cold but, come on people...leave your problems at the door.

If you wake up and don't feel well call in sick...don't try make it...most of the time it doesn't work. Monday morning I walked into my patients room, she was on the phone, as I stood at the end of her bed she says into the phone, "Ok, I have to go, I have to unload on these people." That's a good way to start your day. She was unhappy about her entire stay and felt the need to tell me all of it before I could even introduce myself. She showed me her arm where she had had blood drawn and "someone" had taken the tape off and also removed her skin. She wanted me to call the doctor to see what I could do for it. I wanted to laugh, was she serious, call a doctor at 8 am on a Monday morning and tell him his patient has a tape burn and wants something for it. Can you imagine that conversation? I told her we usually don't apply anything to a tape burn...well, that was the wrong thing to say, she was livid that I said that to her. Then I asked her what she wanted me to put on the tape burn. I thought she was going to explode right in front of me, "You are supposed to be taking care of me. How is it that you don't know what to do? Why don't you just go call the doctor and come back when you have some answers?" So, I left the room. My poor extern was standing right by my side the whole time. I composed myself and called the doctor's PA, all I had to do was mention who I was calling about and he chuckled and asked what she wanted now. I got her neosporin and she wanted Benedryl cream so, I got her that too. I had my extern take it to her and basically take care of her for most of the day. Her heart rate dipped to 39 so I went to check on her, her husband was there as well. She was fine and proceeded to tell me about the nurse who was in that morning and gave her major attitude and how she gave it right back...then, I told her it was me. Usually I would let it go and be glad that she didn't remember our earlier encounter, but she was so blatantly mean to me I couldn't let it go. I ended up discharging her after much delay and irritation on both parts. It was a week.

I had a patient who lives 2 hours away and was brought by helicopter for a heart cath, she ended up in the ICU and then came to tele, her husband didn't visit the whole time she was there. She could press her call light but couldn't press the buttons on the bed to raise the head of the bed, ya gotta love that. It was sad, she was lonely I'm sure, but the odd thing was that she didn't want to go back to the city she lived in for her rehabilitation. I told her she would be closer to her husband but she said he wouldn't visit her anyway that he was busy. I had another patient who lived in another part of the state who's wife would call me 3 and 4 times a day. She didn't want to talk to the patient she wanted to talk to me and tell me how she couldn't come and visit and how she had bills to pay and on and on and on. These are the things that slow me down and keep me from my patients. That's why I say save the drama for your mama. I want to go to work and care for my patients and do my job. I know we need to take care of the whole person but I think they need to be an active participant in their care. A lot of people just come to the hospital and expect us to fix them without them having to do anything or change any of their ways. And when the return in a week or so with the same problem because they went home and continued to do the same things they did that got them into trouble in the first place. Just frustrating.

So, my extern is gone, he had a great time and I think he learned a lot. He won't be working in tele, it's just too busy for him. At least he got to see what it's like. Sorry for all the complaining but, I had to let it out. Remember first do no harm.

It's just rain people

2007-02-21T14:03:00.000-07:00

OK, so it's been raining here. It's like no other place I have ever been in the rain. People actually go outside in the rain. They love it. They can't drive in it, but the love it. We were leaving the hospital the other night, my husband/chauffeur behind the wheel as usual, at it took us forever to get home. It's usually a 20 minute ride...almost 45 minutes! My husband is not the most patient man, especially when it comes to driving. He was like a caged animal between the cars. They were driving like it was ice on the road. Yeah, there were some spots of standing water but not a lot. It was a sight. You can tell a native Arizonan right away , just say it's going to rain and watch them light up. Amazing.
I have been blessed with an extra pair of hands this past week. I have an extern, he is done with school and has to work 96 hours with a preceptor. I feel lucky to be able to help mold new nurse. We had a patient with an amputation and a feeding tube and a central line and oxygen and a catheter. He was so nervous, didn't want to go in the room. I walked into the room and started talking to her, she's had a stroke so she can't talk back very well, but nods her head yes and no. I talk to her like I'm talking to you, like I do with all my patients. We flush her IV and check her feeding tube, reposition her and that's that. It took him the rest of the day to be comfortable enough to go into the room without me but he did it. Later, we sent her home, after we removed her IV and her catheter and flushed her feeding tube. He did finally admit he was afraid to go in the room. It's OK to be apprehensive about something new that you haven't encountered before, but you don't have to let anyone know. Portrayed confidence is just as good as confidence as long as it's believable. I'm not saying to do things you don't know how to without asking questions. I'm talking about walking in that patients room and making them feel confident that you will take care of them and keep them safe. Most of them are scared, even if they don't say it. Make them feel at ease and safe most of all. I have my extern for another 4 shifts so, we'll see what I can get him into.
Remember first do no harm.

Valentines day

2007-02-14T09:44:00.000-07:00

What could be more romantic then a gondola ride? I bet the line at the Venetian is way long today. Wish I was there to see it. We thought about going to Sedona for the day but the weather is supposed to be pretty cold and snowy..not my idea of a fun Valentine's day. I think we will stay home by the fire place or maybe take a walk in the sunshine, while it lasts...supposed to rain tonight. It beats working though.
I am actually taking 2 days in a row off. Ok, I have to go to the hospital tomorrow for a mandatory inservice or I will not be allowed to work, I found this out yesterday, so, I was planning on taking 2 days in a row off. I think it's the first time in a month I have had more than one day in a row off. Not that I am complaining, I am here to work and everyday I go in with a smile on my face and a good attitude. I don't always leave that way but, I try. There are still a lot of people leaving and changing positions and new travelers coming in and a lot of new hires being oriented. 2 weeks ago I oriented a nurse who had worked at the hospital a year ago and had gone off to do home health so she could have more time with her kids. It turns out she needs something more stable with a more flexible schedule, so she came back. The 2 days she oriented with me there were actually 7 nurses on the unit..3 orientees in all. It was a little crowded but it worked. Just funny that they pick me the traveler to orient new staff.
Did you ever work with someone who told you their whole life story the first time you met them? What's up with that? I like the people I work with but, we work on a need to know basis. If I don't need to know something about you, don't tell me. I don't care where your piercings are or were. I don't need to see all your tattoos the first time we work together. I don't want to hear about your divorce, your DUI, your bankruptcy, or your love life in our first 12 hour shift together. Is that wrong? Seems like it happens to me alot, is it me?
So, interesting patients....hmmmm...I had a 572lb patient. That's always fun, had to get the special bed. I gave him a bath, with some assistance, he was grateful but it was difficult to say the least. It took only 4 of us to move him up in the bed because he was able to help. Hey I was happy he was able to help. He ended up going to the ICU with a CO2 of over 100 (very bad). Other than that nothing exciting, same old stuff.
As always first do no harm.

Just another day

2007-01-29T09:14:00.000-07:00

So, it's been a long week. Not really a difficult one since I had an extra set of hands this week. First I got a new nurse from the Phillipines that worked with me. His regular preceptor was out sick. He's doing very well. I can't even imagine how hard it must be to move to a new country to find work. Then over the weekend I had a nurse with me who is getting back into hospital nursing. That was really easy. Now, finally a few days off to rest.
I went to the uniform store last week and was looking for skirts. I know, don't pass out or anything. Nurses used to were skirts all the time. The store I went to had one style, in 2 colors. Wow, no dresses either. So, I bought the skirts and wore them to work. It was an amazing response. Everyone stared like they had never seen a skirt before. One transporter actually said,"I didn't know they made uniform skirts!" Pretty funny. I actually was more comfortable and no it didn't restrict my movement at all. I'm suprized more people out here in Arizona don't wear them. Just throwing it out there to remind you all that you have a choice.
I worked with a traveler yesterday that I recognized. I thought maybe I worked with her there at Good Sam but, it turns out we worked on the same floor on my first assignment in Denver in 2001. Small world, huh? We talked about where we had been. She actually went to NYC and worked days as a med-surg nurse. 8-1 patient ratio....crazy. She said she had run into another nurse at Good Sam who also had worked at St.Joe's in Denver. It just made me think of how lucky I am to be able to do what I do. To travel across the country and work and meet all kinds of people and see things many people will never see. Some of the people I work with have never been outside of Arizona. Many people have been more places than I have been as well,but I feel very fortunate. Maybe that's why I can remain so positive at work, I really do enjoy what I do and my life as well. I don't think there are a lot of people out there who feel the same. I hear a lot of complaining, I just try not to add to it. Remember............. first do no harm.

Following your patients

2007-01-18T09:31:00.000-07:00

Yeah, I got a day off and it's the week of the Barrett-Jackson car auction here in Scottsdale,AZ. I was so excited! We spent all afternoon looking at the cars. We got to see the stage and everything. Now watching it on TV makes it that much more exciting. I was watching it Tuesday night and I remembered seeing some of the cars. Very cool.
So, work has been good. I got to work on a different pod. They reserve 2 pods for post cardiac cath patients and most of the nurses that workover there can pull the arterial sheaths...which is why I don't normally work over there. But,it was a good experience.I got to pull a venous sheath, with someone watching,it was pretty easy, just like pulling a central line.
I love it when I connect with my patients and am able to see that I have made a difference. I took care of a liver failure patient just after Christmas for 5 days in a row.She was really cool to talk to, she's a Army lifer...20 years, and so is her husband. She also has a friend that came from the east coast to visit with her. That, I thought, was a great gesture of friendship. Anyway, she's been in the hospital since before Christmas, waiting for a liver transplant. While she was my patient I had pet therapy come to visit her because she missed her dog. Then I arranged it so she could go outside and her husband brought her dog, you should have seen her face, it was very rewarding. She was moved up to the floor where they take care of the liver patients but I have been going up a couple of times a week to visit her and her husband. They really seem to appreciate it. I went to visit her last Friday and she was sleeping . Saturday I went to visit and she was not there, she had gone to surgery to get her transplant. My heart jumped, I was so happy for her! Now, if you have never had the experience of taking care of a patient in liver failure, I'll paint a brief picture. They are jaundice, skin and sclera, they have a huge abdomen from ascities and we generally make their life miserable by giving them Lactulose to get rid of the ammonia that builds up in their body. They lactulose gives them awful smelling diarrhea, not that there is any good smelling diarrhea, but this stuff is usually pretty bad. They have a difficult time controlling their bowels with it as well. Sounds wonderful, doesn't it? Most of these patients are very discouraged and some are very angry. Maybe that's why I like my patient so much. She really kept her spirits up, she had some down days but she kept her sense of humor. So, I went to see her yesterday because they transferred her out of the ICU and back to the liver floor...she looks so good! No more yellow eyes! Any the worry has eased from her husbands face a little. I smiled the rest of the day! I know her journey is no where near over but I'm so happy it's headed in the right direction. It makes me feel like I can do this for a little longer.
Someone e-mailed me and said it sounded like I don't like my job... I hope I don't come across that way. I do love my job . I just get frustrated. Remember first do no harm.

Doctors Progress Notes

2007-01-10T14:05:00.000-07:00

Ok, I had a couple of different ideas for my blog today. Then I was cleaning out my closet, no, really,it's not a metaphor or anything (although I don't mind listenening to Eminem every now and then). I really was cleaning out my closet and I came across some doctors progress notes that I had copied way back when I was working my first job. I had to make them the subject of the blog. Now, as a nurse, you can get a lot of good information from the doctors progress notes, if you can read them that is. They write about their findings and their plan for the patients care. There was this doctor, who shall remain nameless, who wrote all kinds of weird stories and very odd orders. Needless to say he is excentric, but his patients loved him. His handwriting was atrocious which made deciphering his orders and notes that much more difficult.
I hope you enjoy and get a good chuckle from this actual prgress note.
Chief Complaint:
" I fell honey."
History of present illness:
This 92-year-old white female fell out of bed and she was brought here by the squad. Dr.____ phoned me and said she broke her right hip, which is correct. The lady has a history of electrolyte imbalance, hypothyroidism and postural hypotension. She is 92 and demented. I made my way to ____ Emergency Room, while every erstwhile administrator or attorney had taken vacation through Wednesday, because after all, you know it is Independence Day on Tuesday. However, there is no Independence for the lacky physicians, as myself, who struggle along for a pittance of remuneration. Perhaps I ought to have a Boston Tea Party. In any event, 'the patient' was lying there in the gurney with her two daughters present. She knew old Doc ____ , the kindly old soul.
Physical Examination:
Vital Signs. Her blood pressure was 130/80, heart rate 82 and respirations 12
Lungs: The lungs were clear.
Heart: The heart was sinus rhythm.
Extremities: The right hip was swollen with decreased motion.
Plan:
I said I would get ______, an orthopedist, Dr.___ to clear her heart-wise and Dr._________ to evaluate her sensorium. Therefore, we feel it is safe to admit Mrs._____ and we pray for her.
Wow, that is a piece of art isn't it? I am not sure if this particular physician is still practicing. But, I remember him still carrying the old leather doctors bag with him everyday...once we got a peek inside, it was full of saltine crackers and ginger ale from the refrigerator on the unit. Go figure, huh? Remember...first do no harm.

The first week of the new year

2007-01-07T18:55:00.000-07:00

Ya gotta love that sign..it just exudes fun. Hopefully a sign of what is to come for the new year...fun. The first week was full of work for me. 5 days this past week...not in a row, but I could have if I had wanted to. The last 2 days were pretty exciting. Friday I discharged all 4 of my patients...I just love when that happens, NOT. Yeah because most jobs if you finish all your work you get to go home, right? Not in the hospital, we'll just find you more patients. I'm not complaining, I like to work and make money. I prefer days when I don't have to work so hard though. 3 of my patients went home and I sent one poor soul to the ICU for Cpap.She came in with pneumonia, a chronic copd patient, she just waited too long to come in and what we were doing wasn't helping. She had gotten her lasix and steroids and antibiotics but by noon she was on a venturi mask at 28% with a pulse ox of 90....not good, plus she was really sleepy. All that equals increased CO2 retention and someone who is quickly losing the drive to breathe. I called the resident who ordered ABG's and a trip to the ICU. Hopefully she will be back soon. Saturday I only sent one person home and got one from the ICU and then transferred another one to another tele unit due to staffing issues. Yeah, it always seemed to come at the end of the shift. My patient,who spoke very little English was so nice about moving.That made it all better. Attitude is everything.

So, I survived the first full moon of the year. It was pretty mild for me, thank goodness, as always with a little help from my friends. I can't tell you enough how much it means to be a good team player. I do my work and help my co-workers, including transporters and secretaries , even my nursing assistants. A lot of people beg to differ with me on that last one but, a kind word or a little assistance goes a long way to making you have a good day. You've been there, walk on the floor and you can feel the aura depending on who is working that day. You have to be a little in tune to it, but it doesn't take long. And any one person has the ability to uplift the mood on the unit, if even for a moment, it can make the difference between a good day and one of "those" days. It does take energy and a desire to do it but it's worth the effort most days. If you have the energy.

Remember, first do no harm.

Christmas in Vegas

2007-01-02T18:01:00.000-07:00

So, I got to spend Christmas in Las Vegas. One of the reasons I work so hard all year. It was fun. We got to see all the sights, all the Christmas decorations. This is the Christmas tree in the botanical gardens at the Bellagio. They always have a spectacular display. The crowds were massive but, it was worth it. We saw the trees in front of Caesars Palace and the one on Fremont street. The fountains at Bellagio were set to Christmas music and the weather was perfect. We also got to see them take down the tree on Fremont street the next morning. Amazing how all of a sudden it's over and life goes back to normal. Why does it? Why not have that feeling all year. After all it's a feeling in your heart, isn't it?

Yeah, I'm a dreamer.

I heard it was pretty awful at work. Not enough nurses and all the sickest patients of course. Hats off to all the great people who worked that day and spent it away from their families. I have had to do it many times. It's really hard for the new nurses especially if they didn't work in a hospital setting before or during school. Most families don't understand. I remember so well... trying to explain to my friends why I couldn't go out on New Years Eve or to my new husband why we couldn't spend Christmas together. It's a whole new world...one that not many people understand. It's unfortunate because it adds just a little more stress to the holiday season and the new nurses life.

I returned from Vegas and had one more day off then it was 5 in a row. I couldn't have made it through that last day without the help of my friend and co-worker Mike. We laughed and joked through out the day and made it through. Thanks Mike.

This time of year is also when the travelers contracts are ending, usually right before or after the holidays..it's weird it just seems to work out that way. It's odd to stay on and see them leave when I am usually leaving too. My friend Christie is headed to Bakersfield. I wish travelers would talk to each other more before they make their decisions. She is headed to Mercy hospital..I worked there a couple of times before I went to Mercy Southwest...it was very busy and not terribly friendly. Hopefully things have changed and she has a great time. My friend Madessa was headed to Columbus so we will catch up to each other later this spring. And Carolyn, lucky dog, is headed back to Hawaii today. She was great to work with. She mentioned that she is writing a book about travel nursing... I wish her all the luck and if there is anything I can contribute...let me know.

The hospital is still filled with the really sick left over from the holidays, so the days are not so easy. Hopefully we will get a little relief soon, but not likely with the full moon. It was on the 3rd I believe so, we have 3 more days of craziness, woohoo! I know people don't believe it but, it is true, crazy things happen when there is a full moon. So, I have that to look forward to.

The other thing is my traveler friends Jeannie and Don are planning to come to Phoenix. They are currently in sunny, humid West Palm Beach Florida. The gambling is not so good there so they are headed this way next month. I can't wait!!!!! We had a great time here in Phoenix last time and a lot of fun in Napa. It's funny how sometime you meet people and stay in touch forever and some people you really like and want to keep in touch with don't make the effort. Weird huh?

Well, hopefully I'll have a great story next time from this full moon time. Remember, first, do no harm.

Travel nursing basics

2006-12-22T09:46:00.000-07:00

Hi all, I am blogging this time in reply to a comment on my last post. Lots of nurses and nurses-to-be out there still have lots of questions on how this travel thing works. I understand, I had lots of questions when I started too. Here are the basics as I see them, please send questions if you have them. First, most companies won't hire a new grad, they require at least a year of experience. I think a little longer would be better, but, I started traveling after 10 years of experience. There are tons of companies out there, like going to buy a car, have a list of things you must have and the rest is fluff. I require insurance day one. I refuse to pay for a one bedroom furnished apartment. I require a TV and some place that is cable ready. I need a first floor apartment. All these little things you can ask for. You can ask for a bigger apartment but most of the time you will have to pay a little. You can travel with whomever you want, husband, boyfriend, kids, dog,cats, or another nurse. You generally get travel money at the beginning and the end of your contract in your first and last paycheck. It's all about the same 400-800 dollars. I require weekly paychecks not bi-weekly. You can stay with one company or switch with every assignment. For me it all depends on who has what I want. Believe me not all companies have assignments in all the cities where you want to go. Sometimes they do and you can see who will pay you the most or give you better housing. Assignments are 4 weeks to 6 months or longer if you extend. I have not done a 4 week assignment but I think I would. I have been here in Phoenix since August and plan to stay until April. Whether you stay or not depends on the hospitals needs and how well you get along with others. Being a traveler means being flexible and calm. I have been floated after 4 hours on my unit, one time after I got report in the morning and just started seeing my patients I was asked to go to another unit. I smiled and said sure, if that's what you need. We are here, not as doormats, but as helpers. If you treat others as you wish to be treated, you won't be mistreated. Most hospitals don't purposely try to aggrevate their travelers, they know we have a network and let others know which places treat you well. I don't expect to be treated like a staff member, because I am not, and I don't wish to be...I am there to fill a need. Most hospitals give you 2 days orientation, one day of half hospital orientation and half paperwork and a day of orientation on the floor. Some places give more, I have had up to a week of orientation at some hospitals which I think is great, it's like free money to me. All I have to do is sit in a classroom and stay awake for 8 hours? No problem. I also see it as a waste of money for them. I won't retain half the stuff they are trying to tell me once I get out there. Lots of traveleres complain about their schedules, I think it's a waste of time to complain. If there is a certain day or days you have to have off, have it put into your contract or tell the staffing person on the first day of your orientation. We have to be flexible. I personally love to work weekends, there are less doctors around and on the weekdays I can go and shop and play while people are at work. Hmmm, what else? I travel with my husband and our dog. No, he does not have a 9-5 job. He sells on Ebay and does all the house work, plus he drives me to and from work. It's a rough job, but he got used to it. I have met people that travel with their husbands or boyfriends and they get jobs in each town they go to. I also have friends who do exactly what we do, I work and he stays home and does housework and cooks. It can get rather boring for him but he tolerates it because it's better than the alternative. Yes, we survive very well on one income because we have no housing costs. The hard part is the in between assignment times...we have to plan for the trip to the next assignment and for the amount of time I will not get a check. But, a little planning and it's no problem. Yes, I get to pick where I want to go and for how long. I have left an assignment without notice, but we had our own housing at the time so we incurred no cost. If we had lived in corporate housing we would be responsible for the remainder of the cost of the housing. Yes, I make lots of friends along the way and it's hard to leave. But, sometime your friends follow you when you go and it's a blast. Well, can't think of any more...send me your questions. Happy travels and first do no harm.

Nurse Extern

2006-12-10T17:36:00.000-07:00

Hi all, I've been really busy with the holidays and working. It's amazing to me how many people come and go at Good Sam. One nurse I worked with yesterday is moving to Texas just before Christmas, too expensive to live in Phoenix plus she is a country girl. She grew up in the midwest and so did her husband, they ended up out here because of college. Arizona State University is one of the largest universities in the country. Also, one of our nurses is fulfilling her National Guard duties this week and next week. That's how I got my extra set of hands. It's really nice to have another person to work with, especially when they want to learn and work. It's funny she's completely amazed that we get out of work on time. I told her it comes with experience. I worked with her all last week, we had a chest tube and a new peg tube, the other nurses on the floor had some patients that got really sick so she got to experience that as well. One of them was going in and out of V-Tach and the other one was in respiratory distress and had to be intubated and they were both taken to ICU. All that before 9 am...I hate mornings like that. But my extern got to see what all happens, the code team and the resource nurses showed up and we were able to focus on the rest of the patients. Giving insulin and pain meds to the other nurses patients and making sure they are all safe. It was a good team work experience. I really enjoy teaching new nurses, I know some people don't. I spoke with another nurse who also has an extern, but all the extern wants to do is talk about her personal life and go on breaks. I have a really hard time with people like that. I am at work to work and take care of people, socializing is low on my list of priorities. Maybe that comes from experience as well, maybe it's just a character flaw. Either way, I'll keep it and I think my patients appreciate it as well.

Other than that I'm trying to get my Christmas shopping done, mostly online, while working 48+ hours a week...not easy but it will be worth it. Because on Christmas day I will be in my favorite place ....Las Vegas. Nothing like the sound of slot machines and Christmas carols...it's amazing. I hope you all have a great holiday...remember first do no harm.

I guess we are human

2006-11-19T11:13:00.000-07:00

Hi all. It's been a tough week. One of the fantastic nurses I work with was killed in a tragic accident. It hit me like a lead balloon. This guy I had just seen 3 or 4 days before, someone you expect to be there, just won't be there any more. I know, we in the medical field deal with death all the time, but this time it's personal. This was a great nurse, I think he had been there at Good Sam for almost 20 years. He was one of the go-to guys, somebody who knew everything, or at least had an answer for you. If you needed a hand, he'd help you. His passion was hunting and Army stuff. He actually was supposed to go deer hunting last weekend. Just hard to believe he won't be back. There is a memorial service on Monday and I volunteered to work so some of the people who worked with him for years could go. The hard part is that no one is saying what happened, just that it was a tragic accident. Even the obituary was short and to the point, so you all know how the rumor mill is in a hospital. There are so many rumors about what happened, it would just be better if we knew what happened. I have not been a part of the rumor making or passing on. I think he deserves better than that and I tell the people who come to me with rumors the same thing. Hopefully next week is better, and I pray the law of 3's doesn't come this time. Remember first do no harm.

ACLS

2006-11-15T19:46:00.000-07:00

So,I have been away studying for my ACLS renewal. Yeah, I've had my ACLS for 6 years now and I still study before the class. Luckily because I have had it before I don't have to go for the full 2 days, you just have to do that the first time. Being a traveler,my company doesn't pay for the renewal. Last time was here in Phoenix, I renewed at the hospital where I was working only it wasn't American Heart. It was ASHI...who ever they are, it was the same content but a different company and some hospitals would not accept it. If you haven't taken it, it's not so bad...and if you are thinking of working in ER,Tele,ICU,OR... it's probably going to be a must have. Years ago I guess it was grueling, it was run by doctors who intimidated the participants and lots of people flunked. Today, it's mostly run by nurses and the atmosphere is one of learning not intimidating. I went to a privately owned company that has the ACLS BLS and EMT classes. The cost was $130, but I got 8 CEU's. (some consolation) Part of this years ACLS courses have to have a BLS component because of all the recent changes. If it's been a while since you took it...I'll give you some highlights. Everyone gets 100 compressions per minute, the ratio is 30:2 for everyone unless it's an adolescent or infant 2 person, then you can do 15:2,the breathing is slow and deep,no more constant checking for a pulse, and big emphasis on good compressions with full chest recoil and early AED use. The instructor I had added another component that I hadn't had before...drugs of abuse. Maybe it's because of being in this lovely border state with no fences and the #1 rating for drug trafficking. The drugs come across the border into Arizona and get trafficked out to the rest of the US. Arizona is #2 in Meth manufacturing. Stuff they don't tell ya before you move here, glad I'm just visiting.
She went over date rape drugs and what effects the different drugs have on people. She sited a great website that gives information about drugs....www.erowid.org. It's a great thing to think about when your patients aren't responding to treatment the way they should...knowing these drugs and how they make people react can be a great tool.
She also talked about working at the poison control center...which I never thought about as a nurse but what a cool job. She had some great stories especially about Thanksgiving. I love nurse stories, so I'll share some I heard today. A lady made mashed potatoes with evaporated milk that was brown. She tried the mashed potatoes because they were white after they were whipped and she said they tasted fine. She called the poison control center to see if they thought she could serve the potatoes....of course the answer was no because evaporated milk is supposed to be white and just because she tried them and they tasted fine doesn't mean she should serve them...she was not happy, because she had to go to the store and start over with boxed mashed potatoes. Another caller said she had a fire in the oven where her Thanksgiving casseroles were, they had put the fire out with the home fire extinguisher. The casseroles were covered with foil. She wanted to know if she could serve them.....Uh...no. That fire extinguisher stuff is airborne it gets everywhere. She claimed it was probably water because she didn't see any foam...water doesn't put out grease fires in an oven so, no it wasn't water and no you can't serve the food. The sad thing is she still had the turkey, stuffing, vegetables, mashed potatoes and desserts and didn't think that was enough food. Incredible!!! So, if you are looking for some good stories, you might want to consider working at the poison control center in your town. Plus you get to help people, without worrying about hurting your back...lol. Remember first do no harm.

Just Work

2006-11-06T17:42:00.000-07:00

Hello from sunny Phoenix, I still find it amazing,coming from the frigid Northeast, that November can be so beautiful. The mornings and evenings are cool, not cold, but I am finally able to wear my jeans and long sleeved shirts. The days are sunny with blue skies and warm air, still wearing shorts and tanks tops, we even have to have the air conditioning on most days. Sounds awful, huh? I just can't believe the number of people who dislike where they live and stay there. Every assignment I go on people tell me how much they would like to travel but.....there's always a but. Your desire has to be bigger than your but or you'll never do it. Recently I've been working with some new grads who are all envious of my traveling, they can't wait to have enough experience to travel and I encourage it. It's a great way to see the country and learn new things. I also encourage people to become nurses, it's a great career. There are so many different avenues to take in nursing, if you don't like one , try another.
I had a great idea for a blog the other day and now I can't remember what it was. I hate when that happens. Does that mean I'm getting old? I think it means I just have too much information in my brain. Too many drug names and generic names and dosages and calculations, phone numbers ,doctors names, recruiters...just overload ya know. Plus I have been working 4 and 5 twelve hour shifts a week, that will definitely overload ya. I have heard of nurse working 6 and 7 twelves a week but honestly, how long can you keep that pace up without hurting yourself or someone else?
Work has been good, lots of overtime available. I got Christmas off and Thanksgiving too...I am working New Years Eve and New Years Day...but, it's day shift so it's not so bad, and hopefully it will be slow. I feel for some of the travelers that are coming in now and the ones that came after I did, they are all working Christmas. That's one down fall of nursing, someone has to work on the holidays, all the holidays, the place doesn't close ever. It's an amazing concept really, 24 hours a day 7 days a week, 365 days a year, hospitals never close. When I was in Rhode Island the nurses all belonged to the union and they had mandatory overtime..and it was used all the time. I would hate that. I like my overtime when I want to do it.
Well , remember first do no harm.

Learning

2006-10-19T16:33:00.000-07:00

So, this past week I had a student. I love students, they make me slow down and think. As a nurse practicing for way too many years I find myself just going about my day, doing what I need to do for my patients. It's nice to be questioned (by someone other than they families of my patients) about what I am doing and why. I had a male student, it's his second career, he was in business. Quite a change! It's nice to see more men in the field, they bring another perspective. Plus, sometimes, when you work night shift and you have a confused patient, they will think the male nurse is a doctor and they will do whatever they say, like staying in bed...but, of course, I would never use this technique, I have only heard that it works.(lol)
I also signed up to renew my ACLS and BLS. Here's my advice on that subject...get American Heart and stay with it. Don't go for the online things unless you test online and do the skills check in person. Lots of places and people will tell you that they are all created equal...which maybe true, but, you cannot argue that fact with a hospital that won't give you a job because your ACLS came from some different company. I have had travel companies refuse to submit me for a tele job because my ACLS was not American Heart. A lot of hospitals trying to get their Magnet status will only accept American Heart as well. It's just not worth the aggravation.
And, since I mentioned it, what about Magnet Status? What are your thoughts? I have worked in both, I don't see a lot of difference in the actual day to day nursing. It's a great theory and all, but I don't see it.
Lastly, I have to talk about travel and registry nursing. Not as a new grad, maybe if you are and LPN turning RN and have had a lot of experience, otherwise I wouldn't suggest traveling for 2-3 years. You really don't get into your groove until then, and you haven't experienced enough general nursing stuff. But, after that, why would you pick up and move across the country , to somewhere you have never been, on the word of a potential employer? What a gamble!!! Their job is to get you hired, and if they pay for your relocation, then you owe them a year or so of service. Why not do a travel assignment to the city you are thinking of moving to? Feel it out, maybe do one day a week of some registry to see the other hospitals, maybe they are better, before you commit. I just don't understand it. I have a few friends that have done it, moved across the country to somewhere close to family or just somewhere they had vacationed and loved. I have one friend who has done it twice, even after I encouraged her to try travel and gave her names of companies and recruiters. Both times she has regretted her move, sad really, to waste all that time and energy just to be disappointed and unhappy. So, travel is the way to go...finding the right company is a whole other day.....Thanks for listening. Remember first do no harm.

Still getting attached

2006-09-30T15:25:00.000-07:00

Yep that's me by a palm tree and a pond in the desert, ok it's not really in the desert, it's in Scottsdale/Phoenix area. It's a little park called Papago Park that we have visited quite often. It's a nice little oasis. This has been a long week, just really busy at work. I'm finally allowing myself a few days off to relax. I've been taking care of this patient off and on for the last month, and he finally got to go home yesterday. He was flown from a small town north of Phoenix with bilateral collapsed lungs, and has had chest tubes ever since. The diagnosis came back, and it was not a good one. Mesothelioma, that's my second patient this month with the same diagnosis, both worked construction. I lost my own father to lung cancer so it hits me pretty hard sometime to take care of these guys. So, this guy really wanted to go home as you can imagine, I mean his wife and daughter were here but he just wanted to be home. Good Sam hospital has a floor of rooms that families can rent so they can be in the building to visit the patient whenever they are needed. It's really nice for the patient and the family, especially when they live so far away. Unfortunately, the small hospital that he is going to cannot do any type of extensive surgery if it's needed or anything like that. He had to agree to be a DNR in order to go back home. Isn't that sad? I mean this guy is far from the edge he still gets up every morning and shaves and reads the paper, aside from the chest tubes to constant wall suction, he's what we refer to as a walky talky. I would go in every morning and say hello even when he wasn't my patient for the day. Yesterday we shared a tear when he told me about the conditions of his return to home. He was funny and cranky and made me smile and I think he looked forward to seeing me. It's nice to make that connection with your patients and their families. I know we are not supposed to get attached, but sometimes I can't help it. It may take a little out of me when they go but, if it makes their stay more comfortable, what's the harm? Death and terminal illnesses are not some of my favorite subjects. (Much like trachs and colostomies.) But , they have been a major part of my career. Of course, I think death is as much mental as it is physical. I had a patient quite recently that I helped take out to his car in a wheelchair, he got up into the car and petted his dog who was waiting in the car, he died the next day in his home. I guess he was ready. When you have a terminal illness, a lot of times it's a matter of being comfortable with the situation that makes it ok for you to go. I believe we have some control over it...anyway...on to better subjects.
The weather here has been warm about 100 still and, you guessed it, sunny. It should be cooling down soon...either way it's not going to be cold anytime soon. And, that makes me very happy, coming from Cleveland I have had more that enough cold to last a really,really,really long time. Well, remember first do no harm.

Raining again?

2006-09-24T20:25:00.000-07:00

That's right I said it was raining again...only this time inside my apartment. There's a first for everything. Traveling for 5 years never had a flood. And who would think, right here in the desert.The sprinkler head in the living room in the apartment above us broke about 4 in the morning on Thursday. I woke to the sound of water running..only it was coming down inside the window in the living room. It was a pretty freaky sight. The water was coming through the ceiling fan and all the sprinkler heads and the vents from the living room to the dining room to the kitchen. Every phone number I called for the complex went to voice mail so I had to call 911. Yeah the cops came and so did a bunch of firemen, but the alarm that was going off got turned off and so did the water. The firemen did decide to put some holes in our ceiling, it was interesting. The poor guy who lives above us had just had a flood a month or so ago I felt so bad for him. But my company ,Banner professional registry and travel, was right on top of things. They called the apartment complex and got them to find me a new apartment. So we moved in the next day. They made it so simple and they were very caring and helpful. It's so nice to have a company care.
Work is great, I really enjoy working at Good Sam. The staff that is there is very knowledgeable and helpful. I never feel alone. Plus, I am all about the overtime and there's plenty of it. I have been working 4 or 5 days a week. The pay has been great especially after not working regularly for a month. Well, as always first do no harm.

Good Sam

2006-09-14T11:56:00.000-07:00

Hi all, I've been kind of busy can you tell? The above picture shows that it's hot in Phoenix even the cacti are starting to die. It's been over 100 degrees since I arrived...but what did I expect it's Phoenix right? The monsoon season is almost over, so they tell me. Hopefully the humidity will go down...100 degrees and 50% humidity kinda sucks.
The hospital is just as I remembered. Orientation was a little brutal 6:45 to 5:00 in the classroom with different people speaking and a lot of movies and overhead projector things. We got to see the facility's bomb dog...first that I have seen in my travels. In fact, I don't think they had them last time I was here. The second day was 6 hours of computer training...not too bad.
My husband got here 2 days after orientation so we were able to spend some time together before I actually had to work. I had my 2 days of orientation on the floor which were relatively easy...then they canceled me on Labor day. Boy was I mad. I had to pick up a registry day which wasn't too bad. I worked at Banner Desert in Mesa on their tele floor. It was set up oddly but I got the hang of it by the end of the day. I have been able to work the rest of my days at Good Sam. A few people have recognized me from the last time I was there and I have seen some familiar faces. It's not a bad place to work but it's really busy. It makes the days go quickly though. We usually have a 4:1 ratio with one NA for 15 patients. We normally have a transport nurse and a charge nurse for resource. The only difficult times are when you have someone to go to dialysis and the nurse has to take them or if the travel nurse is busy and you have to take them.
Most of the patients are cardiac cath or post open heart surgery so they are pretty motivated. Much unlike the patients I cared for in Salinas which were highly unmotivated. It makes the job easier if the patients want to learn and get better.
There is a large traveler population at this facility which makes you not feel alone. The staff is mostly traveler friendly and they don't go out of their way to give you the worst assignments. As with everywhere else it comes down to how you present yourself. I went through my orientation with a couple of first time travelers and they are going to have a difficult time I think. The worst thing you can do when you first start a travel assignment is talk too much about yourself, especially to the staff. It's always better to listen and not get too personal too early. We all want to fit in but do it slowly rather than quickly. Also, the staff really doesn't want to hear about how things are better at your other hospital.
Just a little advice for ya...well as always first do no harm....

The Valley of the Sun

2006-08-25T09:58:00.001-07:00

So, the valley of the sun...huh. Did somebody do a rain dance before I got here? Wow, I have never seen rain come off of a roof in a sheet. The roads were flooded but the ones I drove on were passable. It was also a spectacular lightning show. Then yesterday afternoon I was laying in the sun at the pool. Go figure.
The Banner Travel and registry has been wonderful. I went yesterday and met them. I had to do some testing and complete my paperwork. I signed my contract and even got my badge. I am so impressed with this company! They sat down and talked with me , gave me several numbers to call if I needed anything. I spoke with the housing person and with the human resources person and got signed up for my insurance as well. This is how it is supposed to work. I have never been treated so professionally by any other company I worked for. Not even the registries that I have worked for. The next closest would have to be the Cleveland office of Intelistaf. I went to their office and they really worked hard to try to find work for me. I sat down with them and they went over all the hospitals that they had contracts with, they asked which shift I would like to work and even got me in touch with their travel division.
Wednesday this week I went to the Phoenix branch of Intelistaf registry...what a different atmosphere. I didn't even get to sit down. The recruiter brought my paperwork out to a half wall by the entrance door to the office and had me sign my paperwork there. She didn't tell me which hospitals they service, didn't review their timesheets, or introduce me to the staffers (people who I will be dealing with to schedule my shifts). I was not impressed. Makes me think twice about whether I want to make them any money. Yes, I need to work, yeas I need the money but I'd like to be treated better. We'll see.
So, for now I am catching up on my blogging and email and gearing up for a long warm winter...I'll put up pics when my camera arrives.