Wow, it has been exactly 6 months today since i got hired at my hospital. 

It has been an amazing journey! And i can’t wait to see what’s ahead. 

I worked 7 nights out of 8, and i am finally off today. I must say that even though i love my work, I get tired too and excited to finally sleep in and play video games.

Anyways, I have learned so much the past half year.. and learning never really stops in nursing. 

Honestly, working this much, dealing w/ crazy alcoholic patients, agitated and non-compliant has been getting me burnt out, and I kind of lost touch of why I fell in love with nursing. I catch myself yelling at my patients for trying to pull on their tubes.. getting annoyed for a pt who won’t open her eyes because of spasticity, more focused w/ charting and getting things done instead of sitting down and listening to my patient vent about his anxieties about being in the ICU.  What happened to me? 

I love reading past posts in this blog because it reminds me of  why I do what I do. 

I don’t want grow up, dreading to go to work every day because I start to hate my job.

I need to always remind myself why i worked so hard to get here when I can take a different route and just be a doctor or cupcake baker instead. lol. 

I love nursing, and I love seeing the power of medicine and caring combined together to save lives.I will continue living and working by that statement, but for now.. i’m enjoying my day off relaxing at home. 

How have you guys been? 

Why i do what i do. 

This is probably one of the questions most nurses face as they are starting their careers in nursing, which shift to take? DAY OR NOC? 

Having worked on both shifts, here’s some of the advantages and disadvantages:

Day shift: BUSY BUSY shift. you have to constantly deal w/ residents, patients and patient’s families.. most procedures are done during the day so you will have trips to the CT Scan, MRI, Surgery.. bedside procedures are also mostly done during the day, and with that being said.. you learn a lot during the day. You are able to manage your time better. The day goes by faster. You’re also able to enjoy your days off better. You’re body can sleep NORMALLY. However, you deal w/ fellow co-workers (esp if you work in the ICU) who have stronger personalities and older (who’s worked in the unit for yearsss) (not really a bad thing btw). You don’t get to really sit down n talk w/ your co-workers and enjoy your shift.. atleast in our unit because it is a teaching hospital and it’s really busy, i mean busy during day shift.

Noc shift: busy shift as well especially if you work in the ICU (not much of a difference w/ day shift except the trips/procedures). you will still need to deal w/ families and residents. You will be able to really set up a routine that works best for you. Chill/younger people work at night. You get to laugh/enjoy during your shift. TEAM WORK is really prominent for night shift nurses. You get to really read more about your patient because you have more time to actually look up stuff in the charts. Fatter paycheck. However, your sleeping cycle will be messed up! i can assure you that. 

Originally, my supervisor wanted me to work on days.. but to be honest, i really like to be able to enjoy my time while working. WORK IS WORK but if you are able to always look forward to working because of your co-workers & the team work at night- it is a big bonus! (i love the day shift crew as well, but i think i click more w/ the younger crowd) Also, even though I am a morning person.. i still stay up on most days playing videogames anyways. hahaha.The sleeping problem will just take a lot of getting used to (blankets on your windows works great).

Overall, i think it really depends on what works for you better. 

So, what shift do you guys prefer?

Going to a different hospital has made me realize that we do a lot in our hospital. It surprises me that most privately owned.. or just MOST hospitals in general have different people/teams doing certain tasks for their ICU patients. They have IV therapists, skin care team, tele tech, care partners and even LIFT TEAMS who turn patients every 2 hours to prevent pressure ulcer. In our hospital, guess who does all of those? the RN (of course w/ the help of other RN workin in the unit). Being a teaching hospital also has made us assertive while talking to residents about our patient’s care. We deal w/ the patient, the family, the doctors. This is why we go home physically and emotionally exhausted. 

I am not complaining. It actually has opened my eyes and have exercised my willpower to actually make a difference taking care of underprivileged patients.. patients who can’t afford insurance and patients who are really sick. It is a tough job, but i found it really rewarding. 

I’d rather start the race on a really hard obstacle, than have it easy and not be prepared for the worst. I am thankful that I was given the opportunity to start my career in an environment like this. 

Last night was my first night on my own. I was put in the ICU w/ two patients. One of my patients was a resp failure old man and the other a 20 yo female w/ encephalitis secondary to teratoma. 

My old man has two peripheral IV lines. one on the right hand and the other on the left. No central line. Around 11pm last night, as I was about to draw blood from him, i noticed that his Left hand was starting to get swollen/puffy. I immediately stopped the infusion and switched his Ativan Drip and IVF tubings to the peripheral IV on the R hand which was patent at that time. I called the doctor, told her about the situation and that WE NEED A LINE. With all these harsh medications to the vein, a central line is a MUST. She told me “It’s okay, just put it on the other peripheral IV”. I said, okay..so i did. she even told me to increase the infusion (which i should’ve questioned). Around 2, i checked on my patient and he was still doing okay. I decided to do my bath early for my other patient. At 3ish in the morning, as the respiratory therapists were doing their ABG blood draws, we noticed that that my old man’s right hand was swollen, purple and firm. It looked really bad. I immediately stopped the infusion, put a warm compress on it and told my charge RN. I called the doctor again and told her “WE NEED A LINE”, the hand was infiltrated and i did this, and that. She said, keep trying to find one and if we can’t find one, we’ll put a line on him in the morning. So i told our charge RN again, then one of the other older nurses said “Lemme try to find a good vein”. As she was trying to start a line, she flipped the right arm and to our shock found a SHITLOAD, lemme tell you a shitload of blisters. it was gross. and it looks like it hurts! It looked so bad. I checked the pulses and it was there. I went to the phone again and told the doctor about the worsening condition of the right arm. She came and evaluated the patient. LONG STORY short, it was IV infiltration gone REALLY BAD. my pt developed non traumatic compartment syndrome. AND I FELT RESPONSIBLE. :( 

The thing is, he was doing good for me, we were going to extubate him that morning. His fever has gone down. His vital signs were stable. BUT Now, he’s going to the OR to get a fasciotomy.. they have to open his arms to take the fluid out. To make me feel better, the doctor said “Thanks for catching it early”. Other RNs in our unit told me “You did the right thing”. “You are a good nurse”. All those things can be true.  but whether true or not.. It didn’t change the way i felt after seeing his poor infiltrated arm.  I felt really horrible. All i can think of is that I could’ve caught it earlier. i keep beating myself up about it. 

As nurses, we always think that we can save people. It reminded me of this quote:

“We all do our jobs with the belief that we are invincible. That is not true, of course, but being shown our inability to save every life hits hard. Eventually the belief in invincibility comes back, because how on earth could you do this job without it?”

I went home, crying. It might seem like it’s not a big deal for someone.. He didn’t die, but the possibility of losing his right arm is there. And it hurts me. That night when i was taking the report from day shift RN, his pleasant wife and daughter was there saying hi to me and telling me how much they want to bring her husband, her dad back to LA (because they live out of town). Now, i don’t even know if i can face them when i go back to the unit tonight. :(

No matter how horrible i feel, i know i can’t really do anything with situations like this. SHIT happens. What matters is how i reacted to it.. and how this experience can make me a better nurse. I feel like I will be an IV NAZI from now on…