Nurse Sean (dot) com

NurseAuction.com Aims To Alleviate Nurse Shortage With Online Nurse Bidding

A new website, NurseAuction.com, has launched in hopes of filling the current and projected void. “The site is based on the law of supply and demand,” said Dr. Olusanya, company founder. “There’s obviously an enormous need for nurses. However, many nurses are leaving the field because they are overworked and underpaid.”

I love the idea of nurses becoming contractors and making a LOT more money!

I have officially finished the classroom portion of my ICU training! It was three long weeks of sitting in a classroom listening to lengthy, yet fascinating, lectures. I learned absolutely TONNES, but I’m glad it’s over. I can’t wait to actually get some hands on practice.

Not that I’m complaining! Getting paid to sit on my butt–not to mention having weekends off–was a nice change.

I have even finished the requisite theory exams that we are required to write. They were as follows: ECG interpretation, Hemodynamics, pharmacology, Pacemakers, defribrillation, and two or three others that I’m having trouble bringing to mind. Now, I just need to work my butt off to get all my return demonstrations done (three times for each skill) so I can start working more independently.

Over the next year, I will take certifications in PA catheters, ACLS, CRRT, as well as code blue team training. I’m extremely eager to gulp down these further skills, but I have to relax and let myself become comfortable. But darnit! I just want to know everything, and now!

I have seven “buddy” shifts left. Now that I have my tests (mentioned above) done, and have completed computer training, I can take a much more hands on role during these shifts than my two previous buddy shifts. I’m a bit tired of just sitting back and observing, desperately trying to figure out what’s going on.

I picked up my uniforms the other day. I love the light greyish-blue colour. I can’t wait to not look like an outsider thanks to my “wrong” coloured scurbs!

Anyway, as you may have noticed, there’s really not a heck of a lot going on. What can I say about sitting in a classroom eight hours a day?

Can I just say…

The ICU is full of the nicest, warmest, most welcoming people I have met in the nursing field so far. The images I’ve both had and heard of the cold, mean, snobby ICU nurse are such a myth!

I just felt the sudden need to mention that.

What a DAY!

Today I helped care for a traumatic brain injury patient, which was a definite first for me! She was sixteen years old and had flipped her car while skipping school see to her forbidden boyfriend.

I think, in my naiivity, I didn’t realize just how sick she was until another nurse came by and shook her head, looked at the ICP, and stated, “You guys have been fighting one heck of a war with this one”

I was absolutely engrossed in the dips, waves, dives, swoops, climbs, peaks and creeps of her ICP, CPP, MAP, and brain tissue oxygenation. All day it was: Mannitol, propofol, ativan, Hypertonic saline, levophed, open the EVD, close the EVD, and on and on.

We weren’t titrating medications, we were titrating hope.

Speaking of EVDs, I actually had the opportunity to see the neurosurgeon drill a hole in her head and guide the EVD into a ventricle. Oddly, the insertion actually seemed a lot less complicated than setting up the lines for the transducer and monitor!

And she was the first person I ever “bagged.” I was standing there as we prepared her for a head CT. “here” said the respiratory therapist. “Bag her for me while I figure out the oxygen tank.” And so I discovered what it feels like to literally keep someone alive just by squeezing a bag.

As I left the unit she was being whisked to the OR to have a bone flap removed. The EVD just wasn’t relieving the pressure.

She will either die soon or have a VERY long recovery. I thing the former is more likely.

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I have never been a fan of Sherri Shepherd from The View. It started with her fundamentalist Christian leanings, progressed with her belief that the world may be flat, and climaxed when she seemed confused that some people believe the earth and society existed before Jesus.

She’s just plain dumb!

I was hoping to find an actual news story to describe what I heard her say on The View today so I could link it to my blog. However, It would appear as though it will be me breaking the story.

Granted, her comments today were not as shocking previous behavior, but it certainly made me roll my eyes.

She was talking about her experience with having the stomach flu last week when she causally mentioned her ambulance ride. Seriously Sherri? You took an ambulance because you had the stomach flu?

Then the story progressed into a commentary about the fact that no cars would move over and let her ambulance by. She related this to the fact that she was in New York, and, well, that’s what New York is like, right?

Actually, Sherri, I’m thinking, nobody moved over because you had the stomach flu and the ambulance was probably going at a normal speed with it’s lights off. I’m sure the drivers were rolling their eyes too.

Of course, I don’t know any further details of the story, so it could have been much more serious, but it just seemed outright silly to me! And the rest of the hosts didn’t even flinch or take the chance to question her on her choice of transportation. Perhaps they too think this is an appropriate use of resources.

Hospital workers fired for snooping in Spears’ files

Updated Fri. Mar. 14 2008 8:49 PM ET

The Associated Press

LOS ANGELES — UCLA Medical Center will fire some employees and discipline others for snooping at the confidential medical records of Britney Spears while she was hospitalized in its psychiatric ward, a hospital official told The Associated Press.

CTV.ca | Hospital workers fired for snooping in Spears’ files

I was browsing at a local bookstore, flipping through Love in the Time of Cholera (a book I keep meaning to buy but never do). Two young women walked behind me, one with a newborn strapped to her. They were mid-conversation.

“And do you know what I heard!?” The lady with the baby said in an urgent, warning voice.

“What?” Her friend responded. I thought I caught a slight tone in her voice that indicated she wished her friend would shut up and stop babbling.

“Now they are saying that epidurals cause autism too!!!! Epidurals are SO evil!”

With my head still buried in the book, I gave a GIANT eye roll. It wasn’t so much about what she was saying (OK, it was. I am so tired of hearing about the increased autism/increased vaccination correlation, and I really don’t want to have to start hearing about it in regards to epidurals) but rather that I’m tired of hearing women shame other women into feeling guilty about using epidurals.

I GET IT! some women think other women are failures if they use them, and that they’re terrible terrible mothers who are obviously directly harming their babies–it’s getting old. And it’s mean to even imply that.

Fortunately, I looked over and saw this woman’s friend rolling her eyes even more than I was. I think she was thinking the exact same thing I was.

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I wanted to respond to a comment left by Lee-Anne on my last post. I was very interested by what she had to say and I have been ruminating on it all day as a result.

I would like to caution you about not getting caught up in all of the technology and remind yourself that beyond everything else there is a person in the bed connected to the technology who has a family who loves him/her.

I don’t find it fascinating to watch a dying heart on a monitor. It represents the end of someone’s life and the sorrow that will follow.

Always remember, it is a privledge to nurse a patient and care for the family when someone is dying.

The reason I wanted to respond was because I completely disagree with part of the sentiment of this comment. I want to emphasize that I respectfully disagree. I don’t disrespect Lee-Anne’s opinion, I only want to share how mine differs.

I simply do not see being fascinated by technology and science as mutually exclusive to nursing practice–even in the case of a dying patient. In fact, my fascination with human biology and medicine is what began my interest in nursing, and it’s what keeps me interested in nursing as I dive into my career.

I understand the ideology that nurses can be swept up in the machinery, monitors, and equipment, completely forgetting that a living being is laying on the bed suffering. It is important to care for the patient rather than the machines–but I fully disagree that it is wrong to be fascinated by these machines at the same time. I must add that I just can’t imagine not being fascinated by dysrhythmias, disease processes, and complex procedures!

Nursing is NOT just hand-holding and kleenex dispensing. It’s also a large set of hands-on skills; it is the implementation and collection of scientific knowledge; it is advocacy; it is ethics; It is SO many things! So, I feel that to diminish the entire facet that includes scientific knowledge as less important than the traditional ideals of “care” is in error.

Perhaps it is only because I am male, or perhaps it is because of my personality, but I’m not a huggy-touch-feely nurse. Being emotionally supportive of families is not my strength. In fact, I think most would consider it awkward if I tried to be emotionally supportive of families in the same ways as females–holding hands, long hugs. I am emotionally supportive, but not likely in the same way many nurses are.

The science and skill of nursing is my strength. Many nurses may find satisfaction in their job from the emotional care of patients/families, but I find my job satisfaction by seeking out knowledge and perfecting procedures. I don’t see anything wrong with this. After all, don’t all nurses differ in terms of strengths and weaknesses?

Put simply and succinctly (I know–too late) I do not feel that it was wrong for me to pursue more knowledge about the electrophysiology of the dying heart. Furthermore, I do not feel it is unethical to be fascinated by this knowledge. Lastly, I understand that it is a privilege to care for a dying patient, that was never forgotten at the moment.

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Learning ICU pharmacology is like someone handing you the “S” section of the dictionary and telling you, “Someday, sometime, somewhere, I’m going to randomly pick a word from the ‘S’ section of the dictionary. If you can’t recite the definition exactly, word-for-word, your patient will die.”

Perhaps that’s an exaggeration, but at least that’s what it feels like as I study drug after drug after drug and desperately try to commit the details to memory. If all the medications came in cool blue florescent bottles, it would make it MUCH more interesting.

I love this simplistic picture of an ICU patient. Does anyone else have an interpretation for that ECG? Clearly a junctional rhythm, or perhaps supraventricular tachycardia, or is it some kind of bundle branch block? It’s definitely not good though. Don’t ask me why, but I think that this picture, stamped on a t-shirt, would be very funky and trendy. All the rage in the staffroom–around the water cooler.

Today I’m in the classroom again. It’s respiratory/ventilator day! Hopefully I will feel a little better when the mystique of the big machine in corner is revealed.

Well, I survived my first shift in the ICU. It was far more overwhelming than I expected and I am totally freaked out. It wasn’t so much the clinical, theoretical, or hands-on stuff that scared me. Instead, it was the panicked realization that I don’t know what to do in any situation–big or small. I have completely left my comfort zone for. If my comfort zone is Mars, I have now found myself in Venus.

My patient today was very interesting. He had acquired gangrene to the back of his thigh. It was so extensive that his hamstring muscle and large masses of his thigh and groin had been removed. When all the packing was out, the femur was clearly visible–as well as the large sciatic nerve. Has anyone else here had to wrap soaked gauze around the sciatic nerve? I’m not positive, but I’m fairly certain it was a rare experience.

On another note, I noticed that strange things are done in the ICU that will take me forever to get used to. For example, my patient’s blood sugar was 7.4 when we checked just after starting a tube feed.

“What are you doing?” I said as I saw my preceptor playing around with some tubing and meds.

“I’ve decided to start an insulin drip.” She said matter-of-factly.

“Really? We can do that?” I said. I could see the smirk on her face as she enjoyed the amateur question.

“Yup, I’ll let the resident know next time he’s around. You’re forgetting just how much autonomy we get here in the ICU.”

Autonomy is one of those things we all want, but it’s fairly daunting when you get it!

New experiences today: I drew my first blood gasses, learned to zero and Arterial line, suctioned through an endotrachial tube, inserted an oral-gastric tube.

My favorite experience of the day: A patient next door was taken off life support. We brought the ECG up on our monitor so I could watch the dying heart. I didn’t even blink once as I watched the rhythm change from normal sinus rhythm to a clearly junctional rhythm, and then the QRS widened more until a text-book agonal rhythm could be seen. Finally, the monitor started flashing “asystole.” Fascinating!

My head honestly hurts from being so incredibly overstimulated.

Now, back to studying ICU pharmacology!