The differences between emergency rooms!

Holy smokes. I just worked my first shift as a travel nurse and let me just say, I LOVE MY OLD JOB (still currently my job, but it’s 17 hours away). We have a lot of ex travel nurses that are in my ER and I’ve been told by numerous people how good our ER actually is. We’ve had nurses leave and come back because ours is better. I know my job is stressful and I bitch about it, but it’s stressful because the expectation is high. Our care is expected to be good by management and we really do try to make our patients happy and comfortable with care that is as fast as possible (which is not always fast, but it’s still good care).

I see how good my job was now. I texted Jon at 7:45 “I haaate it.” The charting system here is absolutely horrific. One of the techs was telling me how their reimbursement is so low but it’s probably because they aren’t documenting properly to get reimbursed because to complete it, it would take forever to find it. The nurses are overworked and the ER was way understaffed. I left at 11:30 and gave report to a nurse of 3 weeks (at this facility- not ever) who was now taking 6 patients. Six. Not six sniffly patients. Six legit patients. ER patients. W.T.F. The patients there are all lined up in beds along the hallway. People have all kinds of visitors sitting in the hallway with them (the one time I worked in a hallway at my job, I said 0 visitors allowed, no exceptions. HIPAA?). What a clusterfuck. And while I did actually really like my preceptor, I jumped in at 3pm and we ended up with 5 patients and it wasn’t until around 8 that she started helping with nursing stuff. I get that she wanted to let me learn, but I’m not sure if letting somebody who knows nothing about the system just completely drown is the best.

I’m a bit weary of traveling again after this because it was just that bad. It made me miss my ER at home where we have our shit together. But at the same time, if I do go to grad school for management, this is all really useful. It’ll look good on my resume (traveling jobs show adaptability, but I’ve also already been employed at my “real job” for 4 years, so I’m also committed to my workplace) and I’ll also have a more well rounded perspective on how to improve a department. These 13 weeks should really fly by though and quite frankly, I’m just looking forward to working a few shifts in my hospital where I actually feel like the care I’m providing is really good because the care that I have time to give here felt almost negligent, and that is definitely not the type of nurse that I would ever want to be.

Working tonight actually made me realize how much I like taking care of my patients. I don’t just want to say hi, start an IV, and leave. I like creating a relationship with my patients and while I knew that I enjoyed some of my patients at home and quite frequently would get complimented on what a great and caring nurse I was, I had no idea how much I actually like doing it (but not for the rest of my life). Those sweet patients make my job worthwhile in a way that I never even noticed and I really hope that over the next 13 weeks, I have enough time to really make a difference in somebody’s time in the ER. I have never worked 8 hours without having some sort of relationship with a patient in the last 6 years that I’ve been in healthcare until tonight, and I really didn’t like having that missing piece.

Travel nursing is coming up!

Monday, Monday! I had a crazy day at work today but something about only having 6 shifts left kind of keeps me grounded. I never even got stressed out. I got annoyed a bit, but not overwhelmed or anything. I had a patient for 4 hours and saw her one time and did I stress? Nope. Not in the last.

I did find out that my ER apparently upped their lowest PRN requirements, so every month I should work 8 weekend hours, 8 on call hours and 8 other hours. Clearly this won’t work. I can’t come home and work two weekends at a time and I also can’t fly home all the time. I talked to the girl who does our scheduling and she basically said if I miss two months in a row, the hospital will terminate me. I then went and spoke with my boss (not about this in depth- but just to let her know my status was dropping down and she’d see me less- she has known for awhile that I was looking to start traveling around this time) and she basically said that they should be able to work with me. I plan on coming home every 3 months or so and working a larger chunk of time- up to 30 days between most assignments. Right now, I’m in a bit of a hurry to get some assignments done so Jon and I can enjoy some of his Christmas break together and with working 8 hour shifts for my first assignment (which my boss knows), I have no idea how I’ll make it home to work that many hours each month. We’ll see what happens though.

My mom and I were talking about it on my way home and she was talking about how I might lose money (definitely on this first assignment), but I think she’s missing that I’ve wanted to do travel nursing since I was in nursing school three years ago! I put it off until I had a bachelor’s and quite frankly, when I stop traveling for good, I’m going to have to go back to work full time so that I can get enough benefits to accrue PTO for maternity leave. So this is it. This is my time. And I may lose some money or I may break even on some assignments which I was not expecting at all, but I’m reminding myself that it’s not all about money and that traveling the US is my dream. My house is still going to be paid for, Jon’s tuition will be paid, and it’ll all work out. And I do still have money in the bank if need be (although not as much as I like in the bank- but enough to be set if I was to be unemployed).

Jessica (my travel buddy who will be living in MA with me) sent me pictures of the house we’ll be living in today. Just the outside- she creeped on the house while the owners are out of town- but it looks awesome. There’s an awesome pond in the backyard and I can’t wait to see what’s in store for us! I also can’t wait to be in this whole travel thing with another person. We’re getting so close!

Alrighty, I’m going to go cut my nails, eat something, and then head to bed. Another shift tomorrow and tomorrow night, I have to study for ENPC (Emergency Nursing Pediatric Course) that I’m taking on Wednesday and Thursday! Have a good night!

Slow run days and nursing licenses

I weighed myself this morning. 98.6. So I’m right around where I am when I’m not working out a lot, which I suppose is good, except I feel way smaller than I remember. My goal is 103lbs, mostly cause unless I really lift heavy a lot, getting to 105lbs is impossible. Those 2lbs are like a mountain to overcome. I’ve been drinking protein every morning, which I’m really not a protein person at all because I think you should just eat what you need in real food, but just to add a little bit extra to my day for right now. I’m using the 365 chocolate whey, which only has 16g of protein per scoop (I’m using 1-1 1/2). My Noosa yogurt has 17g of protein! So it seems a little crazy to buy something extra with less protein than I eat in a cup of yogurt, but I can’t eat that much yogurt or it’d upset my stomach. Sticking to one Noosa a day.

Yesterday morning I woke up around noon (I was working 3p-3a, so I slept in) and had totally missed CrossFit. Instead I decided to go for a quick run since my legs were so sore from Monday’s workout. It took me 21:12 to run exactly 2 miles. That’s really slow and also why I don’t run in the morning. I had no energy AT ALL! It felt like the longest two miles of my life (I kid- all of my PT tests for the Army felt like the longest 2 miles of my life). Then I worked all night and had a surprisingly easy shift.

I slept from 5-11 with a lot of interruptions. I had plans of CrossFit at noon but it was a 1 mile run (I’m sure there is more, but it’s not on the website). I decided to skip it so I can go for a longer run. So I’m eating breakfast and about to do my lab stuff since I have class tonight, possibly meet Jon for lunch if he texts me, and then head out for a run and maybe stop by the gym.

I need to go get a passport photo for my Massachusetts nursing license and also call the board of nursing about a million questions. I’ve realized Georgia is a really difficult state to have to apply for other licenses from with reciprocity because we’re way behind the times. Pain in my ass. And so is the $275 application fee. But Jon and I have decided not to plan a trip to Germany in December for our honeymoon (we’ll go in May instead) so that I’m not stressing about doing two back to back travel nursing assignments. Now I can hopefully enjoy a little more time with Jon over the first 6 months after our wedding!

Okay, off to be productive! It’s 55 and sunny so I’m dying to get outside for a run!

Life: The Right Path

I’m feeling really grateful today. When Jon and I first talked again in December of 2012 and I knew there was the hint of unhappiness and a possible breakup on the horizon, I wondered what would happen with us. I had a lot of conversations with myself (does anybody else talk to themselves in their car?) that if we had the chance, I just wanted closure and that no matter what happened between Jon and me, the outcome would be the right thing. I wasn’t sure if I wanted to get back together with him or not. I had no idea what would happen. But I told myself as our friendship progressed that the right thing would happen with us. I’m not religious, so I didn’t believe that god would take us down the right path or that I should pray about it. I told myself that I would know when the time was right to cut Jon out of my life again if I had to or that we would know if it was right to take the next steps together.

When I joined the Army, I had no idea why I joined. I still don’t know why I joined! I know the my friend was trying to join the Air Force and it sounded fun and I had always thought about doing it, so I tried. When both of us had problems joining the Air Force, we both joined the Army. We didn’t do it together and we actually only saw each other two or three times while our training overlapped, but that’s the only thing that I can even think of that pushed me to join. One deployment later and tons of money and financial benefits with school, I still have no idea why I joined the Army.

I have days where I love being a nurse. I have days where I leave angry and tired and frustrated and knowing that this isn’t what I want to be doing for the rest of my life. I never hate it. I also never wanted to be a nurse growing up and always dreamed of being a teacher. Then I decided not to be a teacher because I didn’t want to student teach and I don’t even really like kids. But through joining the Army, I decided upon nursing. I also met Jon in the Army. I worked all weekend and left work today feeling very grateful for what I’m doing with my career. While ER nursing is probably not going to be my lifelong career and I am still unsure of whether I want to get a masters in management or public health, I have a feeling I’ll just know.

I really feel like life falls together in a series of events that happen at the right time. I don’t necessarily believe that fate is the reason and clearly, if I didn’t make these decisions in life, I would have made other decisions. And maybe I would have been happy on another path. Maybe I’d be a teacher and already married with kids. But right now, I feel like my life is exactly where it should be. I feel like I’m doing the right things for myself and that this will set me up for a future of more of the right things. And while it may feel at times like nothing in life is going right at all and it’s all a big disaster, I come out on top every time, feeling like life ended up a little more in line with the path that I should be on.

Now, Jon made me dinner and rented us some movies, so time to relax before starting on a plethora of biology tomorrow.

ER nursing and “saving lives”

I had to work 8 hours today. No biggie. I had a patient that I have had in the past. I don’t actually remember much about her from the past other than her name. It’s hard to forget. After coming in for increased pain in  her legs due to her neuropathy (for one year), she asked me for a meal immediately and then asked me for pain meds. She rudely asked me for a blanket. Then she rudely stood in the hallway to remind me that I forgot her blankets (no, I did not forget, I was just busy with my other patients with legitimate complaints).

It can be really hard to enjoy being a nurse at times. Really hard. Really really hard. You get it? It can be completely thankless. Patients can be rude. They can be demoralizing. They expect you to bend over backwards when they come in for absolutely nothing and are rude to you the entire time. I have been yelled at, cussed at, told that they want any nurse but me (luckily, only my psych patients have told me that)… I had a psych patient tell me I was provoking her. I was barely saying anything. I’ve had patients refuse to leave but they don’t actually want my help.

But I had a patient a few weeks ago who had coded in the field. EMS brought him in with a heart rate in the 30s and a BP that was 60/palp (so he was in bad shape). We paced him on our monitor until the cardiologist was able to put in a temporary pacemaker. We had him on drips and fluids and were doing our best. He was awake, though confused and 100% concerned with when he would get water to drink, and he looked me straight in the eyes while I was trying to get a manual blood pressure on him and he said, “Thank you for saving my life.”

I’ve said how I feel about ever claiming that my job is “saving lives.” I’m a nurse, just like all other nurses. I’ve been a part of many lives saved, but it’s my job. That’s what I do. Just like the teller at the bank hands me my money or the server at a restaurant brings me my food. I’m just doing my job. And even though I feel like 99% of the time my job includes running through a shitstorm and not even coming out of it with anybody having any gratitude for what I just did, it was really nice to hear that man thank me for saving his life.

(By the way, in my eyes, the EMTs who arrived on scene actually saved his life. They brought him back. Myself, along with two other nurses, an ER physician, a nurse practitioner and doctor with the cardiology group, just kept him alive once he was already saved.).

Nursing is really a difficult job. I dislike it half the time and like it half the time. I never love it. I never hate it. But I’m often very grateful that I’m able to fill these shoes and walk into the ER, alive and healthy, and work my shift helping others. After three years of having patients tell me what a wonderful nurse I am or that I’m the best nurse that they’ve ever hard or that I have the heart for this profession (you know, between the patients who yell at me), I’m starting to believe it.