Nurse Sean (dot) com

It’s 00:43 and I’m between night shifts, and I’m having a happy dreamy night. It’s been a great weekend, and today was particularly great! It included: taking my dog to get his picture taken with Santa, drinking some of the world’s best coffee, and putting up our Christmas tree.

So, right now I’m continuing with the dreamy times (Grey’s Anatomy would be proud of all this dreaminess). I’m sitting in front of my dreamy tree:

And drinking some dreamy coffee that was ground in my new grinder and made in a press:

From one of the bestest dreamiest coffee roasters in the world!

I really can’t wax poetic enough about 49th Parallel coffee. While the Ethiopian Yergacheffe shown above is amazing, their “sleeping woman” is quite honestly the greatest cup of coffee I have ever had in my life. And on order are two more coffees from them that are considered even MORE incredible. I feel like I’ve truly discovered a treasure…and I’m trying to decided whether I should share it or keep it all to myself!

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So, I wanted to catch up on a few things that I’ve been meaning to post about! First of all, I was tagged by Peter over at St. Vincent’s Hospital Darlinghurst. He asked about my proudest moment.

It won’t be a long answer because it is short and simple. My proudest moment was when I received the letter in the mail telling me I passed the RN exam. The size of the accomplishment crashed down on me at that very moment and I bawled. My last day of school, my professor saying she’d recommend me for grad school, and even receiving my diploma didn’t feel as good as that simple scrap of paper stamped “pass.”

And I’m not just saying that because it’s a nursing blog. It was a culmination of so many struggles. I’m still proud of me. Yay!

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Kim over at Emergiblog has been talking about clinical vs. theoretical experience. She put out a call for opinions on the subject. Disappearing John RN has already put in his opinion on the subject.

As for my education, I feel that there was a strong balance between clinical and theoretical nursing. We spent hundreds of hours in the clinical setting putting our lab skills to practice. In fact, I think the only way they could improve our clinical experience would be to go back to hospital training programs.

The issue I had with my education and clinical training is that it offered a Pollyannic and unrealistic. They taught us how to holistically care for patients physically, spiritually, and emotionally. The reality is that the hospital system only supports caring for the physical. If you have time to sit down and talk emotions with your patient, then you have time for more patients!

We work in a system that rewards technical skill over holistic care.

The other issue with the education we received is that they preach a style of nursing that doesn’t exist, and to be honest may never exist. That is, they teach us to be leaders of a team of people. They teach us to delegate tasks to those around us so that we may orchestrate a complete and effective care that (sorry, I’m sounding like a broken record here) cares for the patient holistically.

I think that nursing NEEDS to go to this style of care because as the numbers of RNs wane, we will be replaced with technicians that require strong leadership and supervision. However, I believe that this will take decades to occur because nurses push away the idea more strongly than they fight for nurse/patient ratios.

I, personally, went into nursing thinking I would be exactly what I described: a leader of a team of folks working to care for patients. I truly didn’t know nursing would be as it is–oops! So, for me, the idea of transforming what nursing looks like is an exciting prospect. However, many nurses went into nursing because they loved the idea of caring for patients: washing them, changing them, walking them (I often think we describe caring for patients as we would caring for a dog). To them, the idea of stepping up our focus and moving slightly away from the bedside is a slap in the face to the profession of nursing.

I think nursing will transform, but we won’t allow it to, so it will have to happen out of necessity rather than will.

So, to answer Kim’s question point-blank: I feel that my nursing degree prepared me very well, but it prepared me for the wrong thing!

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Beth over at PixelRN posted some ideas for blogging topics. This one stood out for me:

3. Advice for fellow nurses. Everyone loves to give advice, lets face it. As a nurse blogger, you have the ultimate soapbox!

OK, I don’t have an entire post devoted to the topic, but I did want to answer with my advice. And it’s simple! My advice is to RELAX sometimes. Yes, it’s a stressful, busy, scary, sometimes hopeless job. But please, don’t forget, it’s OK to be yourself, have some fun, laugh occasionally, look for the positive, and as I said:

RELAX!

It’s cold here! Last time I checked it was -18C (I’m not good at fahrenheit conversions for ll the American folks out there), which is even cold for a person like me who hates heat. However, it gives me a chance to bundle up in my 2006 Canadian Winter Olympics gear which I adore.

I have a couple days off before switching back to nights. I have been working 12 hour days for a months now, and I’m ready to be a night person again! I am tired of hearing that alarm go off at 05:00am. It will be nice to be back to where I feel more comfortable.

I was working in our unit’s high observation room for the last few days. I adore working in there! For starters, we have a 2:1 nurse/patient ratio (the room fits four patients). This means that while working together, we get an incredibly good amount of stuff done for our patients. I wish it was always so good.

The other thing I like about the high obs room is the high acuity of the patients. Some nurses can’t stand unstable patients, but I’ll be honest: the more unstable the patient, the more interesting they are to me! This is the reason I fully plan on moving to the ICU and working toward being on the hospital’s code team.

Speaking of the ICU, I wrote another of my critical care nursing course tests yesterday. This one was brutal. It was renal physiology, which I generally find fairly straight forward, logical, and easy to learn. However, I just didn’t have a lot of time I could devote to studying for the test. I don’t have my results back, but I don’t think I will see a mark above 90% like the other tests; and frankly, I don’t deserve a high mark.

Yesterday, we had a large staff meeting. We’re tired of being chronically understaffed; we’re tired of having patients lining the hallways because administration forces us to take many patients over our unit’s capacity; we’re tired of our incompetent manager; we’re tired of so many things.

We compiled a list of our complaints about our manager and the hospital. Then, we backed up all our complaints with research and numerous personal experiences. We also cited our nursing association’s practice standards. Then, one of us (thank God for her!) stood up in front of about thirty unit staff, our manager, and two of her managers, and listed our complaints and demands.

We called for serious action!

We really didn’t get any. The answer we received was basically, “We here what you say, we believe what you say, we understand what you say, but we have no solution…so sorry. You still need to work understaffed and over capacity.”

The only step forward was the creation of a “unit council” that will meet with the goal of coming up with solutions to our problem. The administrators are pushing us to reform our nursing model. They want to use a much more multidisciplinary approach to nursing.

In this model, nurses would be “case managers” as they described it, and would manage a team of multidisciplinary individuals. Instead of providing direct nursing care, the RN would direct a team of individuals to provide care of patients.

They even suggested adding extra staff to the unit, such as: pharm techs, physio techs, Recreation therapists, and whatever else we could imagine. Their thinking is that we could utilize the appropriate resources to provide well-rounded care to our patients.

I personally a very strong advocate of this style of nursing. When I went into nursing, this is actually what I thought being an RN. That is, I thought RNs were the supervisors on the unit that gave orders to LPN’s and NA’s to provide care to patients. I thought they were the case managers that I just described.

I am always embarrassed to admit that when I started nursing school, I didn’t think RN’s did bed baths, or changed diapers, or toileted patients. Even after the first year of nursing school I was under the impression that we were just learning those skills because we would have to supervise others while they performed them. So, it was a bit of a shock in the second year of nursing school when I came to the realization that these tasks WERE a part of my job.

The major opposition to this approach is nurses who went into this profession because they wanted to do the bed baths, toileting, attends changes. They refuse to let go of these items simply because it’s the part of the job they think IS nursing.

As I’m a recently trained nurse, I was taught that being a RN means working at a much higher level. Nursing, the way I was trained, is about being a leader of a multidisciplinary team focused on implementing a holistic plan of care that cares for the patient both physically, spiritually, and mentally.

I truly believe that a lot of nurse’s skills are wasted! We only use a small fraction of our scope of practice. And the fraction we use is stuff that other professionals can perform. It’s stuff that, were it to be let go of, would allow us to work at a higher, more intellectual level, and (God forbed!) be seen as professionals, rather than blue collar workers.

We deserve a step forward in our profession!

Sorry, that was longer than I intended….

After our meeting, we went out to dinner. It was so much fun hanging out with the folks from work and gossiping. I don’t get invited to a lot of events (every event seems to be a bridal shower or baby shower…no men allowed!), so it felt good to be chummy with my friends from work.

Today, I’m looking forward to getting a small amount of Christmas shopping done. But, I’m not too stressed out about it. I typically enjoy doing my shopping closer to Christmas day. Seriously, it just FEELS more like Christmas when you actually buy your presents around Christmas. Buying everything in August just isn’t the same.

I really like the picture I put on this blog. I’m referring to the picture of the nurse on the right that seems to be watching over everything I write. She is hard as stone but appears soft; she is young but is definitely mature; she looks warm-hearted but ready to dispense tough love at a moment’s notice. She has many dichotomies as most nurses do.

It’s as though she is my own personal goddess or Saint that watches over everything I do as a nurse. She follows my evolving practice. She is ready to pick me up off the floor when I’ve had a horrible day. She is ready to pat me on the back when I feel as though I’m really coming along.

Is it strange that I contemplate what a picture on my blog is doing or thinking? I think I’m just imaginative. Any opinions from the mental health nurses out there?

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They say the first year out of school is the hardest. After you’ve finished that year, you’re golden, right? You automatically become a perfect nurse, right?

 I find it hard to believe that in a couple months, my initial year out of school will be done. Some days it feels as though I’m barely ready to pass my very first nursing clinical, let alone be done school and out there working on my own!

I’m in limbo though. Some days I’m treated as the new kid on the block who doesn’t know a thing. Other days, I’m plunged into leadership positions with new staff, graduates and students lined up to ask my opinion. I’m always amazed at how much I know! I really am learning!

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Illness sometimes happens right when you need it to. For the past couple weeks I have felt dopey. My head has been foggy, and some would even say it has been “up my ass.” I have been missing details, moving slowly and struggling to put forth my best effort. And nurses always have to be at their best, right?

So, a few days ago, I came down with a nasty cold. It has forced me to lie on the couch, surrounded by pillows and a quilt, sipping tea, and watching TV. I may still be a bit sick, but my mind feels rested and much MUCH clearer. I feel ready to go!

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I have a confession. I’m supposed to be working on my critical care course right now. I have a test in a few days on the pulmonary system. Right now, I’m learning about perfusion versus ventilation, and what the different ratios between them indicate. I must say, I adore the detail of knowledge that I am gaining. This detailed anatomy/physiology that focuses the main acute care systems is much more appropriate right now than the broad scope of nursing school anatomy.

Let’s face it, it’s nice to know the anatomy of a taste bud, the structure of the eye, and how earwax is produced, but that’s really not what gets me through a shift! This course focuses on the lungs, heart, kidneys, brain, cells, and defense. This is the stuff that I work with on a daily basis—it’s my bread and butter.

I still can’t believe that here in Canada, critical care is so lacking in Universities. Many (like me) spend their entire four-year degree without stepping into or even discussing the ICU or ER. If you want to work there, you need to train for it following your Bachelor’s degree.

Edit: After actually doing the studying, I am feeling completely defeated by pulmonary physiology. This is complex stuff! 

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I have a sinking feeling that this will be ER’s last season on TV. I feel it in my gut. What will I do without ER? I even credit it with sparking my interest in nursing. I highly doubt that Gray’s Anatomy or House could ever do that!

I’m terrified about having that void in my life!

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I hate having to write an entire post twice! Yes, I did indeed type this post twice…ARG!

I recently renewed my membership to The New Democratic Party of Canada. I am very proud of this fact! If I were an American, I would probably be crucified for being part of such a left-wing party. I’m proud to live in a country that doesn’t put you down for supporting a party that supports socialized health care, gay rights/marriage, strong environmental solutions, equality for women/minorities, and strong social programs to help alleviate poverty.

Here’s a link to their position on public/socialized/universal health care.

I have seen so many blog posts/comments and discussions at allnurses.com that are very much against universal health care. I thought I would start a list of reasons I love Canada’s health care system. This will be added to on a continual basis as I think of new reasons or examples.

1. Currently on my unit there is a homeless woman who found refuge at a homeless shelter. The nurses who assessed her at the shelter were worried about her condition and sent her to the hospital. She was dirty, weak, malnourished, and on death’s door.

There is also a very rich businessman who was sent to our unit after many weeks of traveling Canada and the U.S. for opinions on his condition. Every surgeon told him to go to our unit, to our surgeon. He is considered the best of the best.

Both of these people had the exact same condition; a deadly cancer that was slowly killing them and needed to be removed. Both of them received the same surgery from the same surgeon. Both of them received the same care from nurses, physiotherapists, social workers, residents etc. They lived in identical hospital rooms next to each other and recovered at the same rate.

Both patients walked out of the hospital on their feet. The wealthy business man (back in his suit and tie) went back to his mansion and luxurious life, and the homeless woman went to her new apartment with homecare nurses put in place and adequate government funding for her to survive (away from the streets). The social safety net had successfully caught her.

The treatment they had cost approximately $500,000. If health care were privatized, the homeless woman would never have been able to receive the surgery. She would have died on the streets.

When it comes to health care, we are all treated as equals. Some will go home to mansions, some will go home to crappy apartments. However, we will all be treated with respect and dignity when we are sick.

I strongly believe that health care is a right, not a privilege.

2. Hospitals in a socialized health care system are not-for-profit. This is an extremely important detail for many reasons. However, for number two on my list, I want to focus on the idea that in a not-for-profit hospital, health care professionals (read: nurses) are not forced to become customer service agents.

Our hospitals are functional. They aren’t overly “pretty” or filled with pleasantries to attract “customers.” Hospitals here are there to serve the needs of the community, without having to stoop to gimmicks like having food courts in the lobby so that patients will choose that hospital first!

Our professionals are truly professionals and can focus on executing their skills, rather than focusing on whether or not patients like them. We are not insulted by being presented with satisfaction surveys or “customer” complaints. When I’m putting a tube through your nose, poking you with needles, and shoving Foleys in your bladder, is it really an appropriate time to ask if you are happy with me?

I’m not even directly affected by the American system of treating patients as consumers, but I am continually insulted by it. The idea that well-educated, skilled, brilliant professionals can be lowered to feeling like a fast-food worker, is horrifying*. Does an architect, lawyer, or manager submit themselves to satisfaction surveys? NO! They let their work stand for itself. Nurses should the same.

I have never worked within the American system, but I am in love with the Canadian system. I feel it is a much more mature, humane system that treats its patients and employees with respect. The power is balanced between all individuals, rather than just the patient, because we all pay for and use the same system. I know that if I am ever sick, I will receive the same great treatment that I give every day.

*I don’t think fast-food workers should be made to feel like lesser citizens, but unfortunately (and unfairly), they are. Please, for the love of god, be nice to fast-food workers. You have no idea how tough their job is if you have never been there. They are continually treated as lesser citizens, and that is NOT right! I just wanted to clear that up.

I just wanted to say good luck to all the new Canadian grads writing the Canadian Registered Nursing Exam today. It WILL be a long, difficult day, but you will make it!

For those not familiar with the test, it is an eight hour long test made up of hundreds of multiple choice questions, and a very large, daunting section of short answer questions. There are not a lot of questions that force you to know specific data. Instead, it mostly looks at your ability to think through situations and ensure you would act appropriately.

Some complain that the test is too focused on psychosocial/ethical/community issues and doesn’t actually test whether or not someone knows how to be a nurse (i.e. knowing every complication to every drug, knowing every nook and cranny of anatomy etc.). To those people I say, “perhaps you’re defining how to be a nurse wrong.”

All in all, it is just a test! The vast majority of those graduating from a Canadian university will pass (something like 96%) because Canadian universities have standardized curriculum. What I mean is, the test isn’t all that different from the ones you get during your education. If you passed those, you’ll pass this one.

I want to add that I am extremely proud to come from a country where almost every new nurse graduating has a bachelor’s degree! Education is far too undervalued in other countries. Even if you plan to be a bedside nurse for your entire life, PLEASE do not underestimate the value of more education.

Yes, it has been more than a month since my last post. However, after about seven years of blogging, I’m quite aware that my desire to post ebbs and flows. There will be times where I excitedly blog every day. Other times, I will go weeks without posting. Lets face it, blogging is a lot of work! I think the only regret I have is that regular posting generally equals regular readers. I crave the hordes of readers other bloggers have, but they typically post at LEAST once a day.

That’s enough talk about how often I post! Too many of my posts start with a similar speech. I also want to mention that I’m aware that I have been tagged for the “eight random things” meme. I will try writing that in the next couple days. For now, I would like to update my last few weeks!

Believe it or not, I took a vacation! It was the first time I had more than two or three days off in a row since I went to Boston for ten days…four years ago! And before my Boston trip, I hadn’t had more than two or three days off in a row since 1997 when I went to Seattle. One vacation in ten years is insanity! My habit was to just get my vacation paid out.

So, to have two weeks off felt great! I didn’t go anywhere and I didn’t do anything. I watched a lot of television, walked my dog often, played on the Internet, and read. The most exciting experience was buying my new car! I bought a 2007 Galaxy Grey Honda Civic LX coupe with a manual transmission.

The absolute highlight of my vacation was my David Lynch film festival. I watched Eraserhead, Blue Velvet, Mulholland Dr., and several episodes of Twin Peaks…all in the same day. This weekend I am going to see his new movie, INLAND EMPIRE. I’ve heard it described as one of the craziest movie going experiences of all time. Apparently it makes no sense…and well…what else would I expect from David Lynch?

Charlie really is driving me to the brink of insanity. He’s a walking contradiction! He is so easy to train with simple obedience exercises. He has no problem learning how to sit, lie down, loose leash walk, and his recalls are nearly flawless and reliable. Unfortunately, his potty training is getting worse every day (despite taking him out every 2-3 hours and watching closely for signals that he has to pee. He is also SO destructive when it comes to ripping up paper. And after trying everything in the books and out of the mouths of our obedience trainers…he still bites…A LOT! So, sometimes it feels as though we have the greatest, smartest dog, and other times I’m nearly in tears wondering what I’m doing wrong.

Charlie is actually done his puppy classes (sadness). They were incredibly fun! A lot of it involved him just running around socializing (playing) with other dogs. Charlie loves chasing puppies, being chased by puppies, and play fighting with puppies. Even more than that, we adored our Friday nights watching dozens of incredibly cute puppies running and jumping. As one woman put it, “you can feel your blood pressure going down by the minute!”

He will be starting true obedience classes on June 7th. It’s time to get a bit more serious with the training! He will learn to increase his attention span, gain self-control, and all the usual basics (sit, lie down, loose leash walking, etc. etc.). I truly love the facility I’m using. They are so incredibly friendly and knowledgeable!

Well, I have worked three shifts since the end of my vacation. I feel calm and at peace while at work. There is definitely a different vibe within myself while I go about my day. I will admit that I lucked out with my patient assignment, but in general, I feel as though I am starting to really enjoy this career.

Which reminds me!!! I received my RN license in the mail! When people ask me if I’m an RN, I no longer have to answer, “Sort of…I have my degree…and I passed my test…but I’m waiting for my license to arrive in the mail.” Yes, it’s all over and official, I’m the real deal!

It has been fun during the last few days watching the undergraduate nurses starting their jobs on the unit. I’m fascinated by the fact that only one year ago I was exactly where they are now. I am amazed and proud of how far I have come since then. It has been one hell of a year!

Of course, I celebrated my graduation from school and my registration as a nurse by promptly signing up for the “Advanced Studies in Critical Care Nursing” program at Mount Royal College. It is five courses long (physiology, pathophysiology, pharmacology, and assessment of critical care patients, followed by a practicum) and will provide me with the beginning training needed to transition to the ICU or ER. So yes, starting in fall, I will once again be a nursing student! I’m still very disappointed in the lack of critical training in Canadian schools as a basic part of becoming an RN!

Well, after going a month without posting, I could go on for ages. However, this post is getting long! So, I have decided to stop here. I will try to be a better blogger in the coming weeks.

First of all, thank you everyone for your kind messages following my last post declaring that I passed my exam and am now a Registered Nurse (god, just writing that made me swoon with joy). I need to correct myself by stating that I am not a registered nurse quite yet. Let me explain…

I wrote my exam February 7th, 2007. I received my results and I passed, but that does not automatically make me a registered nurse. I do indeed need to actually register with the College and Association of Registered Nurses of Alberta. So, I am still a Grad Nurse in the meantime.

The process to register will probably take awhile. I will be sending them my registration form tomorrow; however, they cannot register me until they receive my transcripts from the University showing that they have granted my degree. Even though I finished my course work in December, the University will not grant my degree until June 14th. So, I probably won’t receive my license until July. Did that make any sense?

The odd thing is that when I receive my license, it is valid retro to February 7th when I wrote my exam. So, Today on April 5th, 2007 I am not a Registered Nurse. However, when I receive my license in July, I will be able to say I was a Registered Nurse on April 5th, 2007. CRAZY!

They definitely need to find an easier way to do this….

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I’m not sure how the continued competencies work elsewhere, but here in Alberta they have a system in which we tell them what we want to learn and how we plan to learn it, then we need to provide evidence that we followed through.

However, you cannot just choose random things to learn. Instead, you have to study CARNA’s list of what they call “indicators,” or competencies that they expect Registered Nurses to have. They expect you to choose 1-3 of these indicators to work on. I chose the following:

1.) “I follow current legislation, standards and policies relevant to my profession and my practice setting.”

I chose this indicator because I feel I rely too much on other nurses when I need to learn a skill. What I mean is, if I don’t know how to do a task, I will just pull aside another nurse and beg for help. I would instead like to focus more on learning from our policies that are set out for us. This way I will learn to do things properly and without bad habits. Furthermore, these policies are in place because they are based on evidence, and even better, they are SAFE!

2.) “I question policies and procedures inconsistent with therapeutic patient/client outcomes, best practices and safety standards”

I am a new nurse and occasionally naive. Far too often I perform orders from doctors without second thought because I trust that they are practicing safely. As we all know, that is not a safe way for ME to practice. An example would be questioning why the doctor has unexpectedly ordered a large bolus of fluid with no real apparent reasons. I would like to work on becoming more comfortable questioning doctor’s orders (and of course the practice of other health care workers).

3.) “I support decisions with evidence-based rationale”

I will admit it…I am a nurse geek. I love researching articles and pouring over the information they supply. What I would like to do is start a collection of journal articles pertinent to the surgical oncology focus of my unit.

I chose number one and number two because I immediately recognized them as weaknesses and have already put effort into improving these indicators, and I recognized number three as something I am passionate about and love to do.

The evidence of my learning will be journals for number one and number two that outline my experiences specific to these indicators and what I learned from these experiences. For number three I plan to create an annotated bibliography that I can add to over time. I may even attempt to organize an online journal club for my unit.

Fortunately, this process is fairly second nature for me since we visited these indicators numerous times throughout my degree, and we even did an extensive and exhaustive version of this for my final focus practicum.

I still think nurses should be paid for this extra work…

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I stood up to the old, cranky, scary nurse on our unit a couple days ago during report following a night shift. A patient had TID insulin ordered 30 min. before meals. The computer had it scheduled for 07:00, 11:00, 17:00. Unfortunately our meals come at 8:30, 12:30, and 18:30. So, I reschedule the medication for 08:00, 12:00, and 18:00. As an extra bonus, the 7:00 insulin no longer fell on my shift and I would not have to check the patient’s blood sugar and draw up the insulin…but this was not the motivation for making the change.

The oncoming nurse was furious that I changed the schedule, since, according to her, the plan was to keep it at the original times. I pressed her for a reason (the first hint that I had more confidence…questioning her is grounds for a yellin’) over and over again but she could not give me one. She just kept saying, “It’s what I decided.” She called me lazy and accused me of changing the schedule so I wouldn’t have to give it.

But, I stood up to her and reminded her that it was ordered 30 min. before meals and for me to give it at 07:00 would be a med error…not to mention not safe. I explained to her that it had been drilled into my head over and over that insulin should be given right before a meal. My last instructor before graduating even insisted that patients had their meal tray in front of them and ready to go before I could give the insulin.

The cranky old nurse stomped away to grumble and complain about me. I went home proud of myself for taking a chance by standing for something I believed in…and I slept well with the belief that I was completely correct in my decision.

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Charlie went to his Bright Puppy classes earlier tonight. What a blast! He spent some time visiting with the other small puppies, worked on sitting and lying down on command, played in all different sizes/types of crates, and played on grooming tables. He has so much fun at these classes (ok, I probably have more fun hanging out with lots and lots of super cute puppies) and it mentally stimulates him into exhaustion!

We are still struggling to get him to go pee/poo on is pad. No matter how diligent we are (we’ve caught him in the act 100% of the time over the past week since deciding we were getting lazy and refocusing our energy), he just randomly picks a spot and goes. Ugh! I hope he figures it out soon. Even a little sign of understanding would be nice. There’s nothing like grown men running across an apartment with a still peeing dog in one hand and a bag of treats in the other…

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My sister had a baby girl a couple of days ago! She had it in the hospital I work in, right before I began my night shift.

YAY!

If you can believe it, I still haven’t gone to see the baby. I will be meeting her for the first time on Sunday at Easter dinner. I can’t wait!

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‘ How much longe can I this u h er keep up?’
— William Shakespeare
Ottawa Citizen
01 Apr 2007

Sleep, nature’s soft nurse. Even after all these years, I still work night shifts. I probably could find a day job or an excuse to get out of them, but I’m not yet ready to say goodbye to the nights. However, on my evening drive to work along the… read more…

Charlie is doing great! Even though he has a splint, he’s been bounding around the house. We haven’t been able to convince him that he’s hurt and needs to REST! We went to our vet today to have the splilnt changed (it is now bright yellow…she promised we could have purple next time), and she gave us some advice on curbing his activity. So, we have him on his lead at all times…he’s either attached to the coffee table or one of our belts. And it’s working! He can no longer fly up and down the hallway or chase after us, or practice trying to get up on the couch.

But the real bonus is that it will help us with house training. We will be able to keep an eye on him at all times. No more sneaking down the hallway to go pee!

We actually took him to puppy playtime on Friday. We were worried about him playing too hard (puppy playtime is all about the puppies running around and play fighting), but we knew that the gentlemen that runs it is a vet and would be able to give us advice. Our plan was to keep him on a lead and just hold him back, letting dogs come to him. He suggested letting him walk around socializing, and only holding him back if he gets out of control.

For most of the time he just hid behind my legs (apparently this is the norm for the first couple times). However, he started to interact and play with dogs in the last ten minutes. He didn’t start playing too hard, but I could tell he wanted to. I can’t wait until his splint is off and he can go full throttle!!!

On top of everything, the vet found a lovely (yet massive) yeast infection in his ear. So, we get to put drops in his ear twice a day! Puppies sure are a handful!!! Not to mention expensive.

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My day shifts on Thurs/Friday were chaos! Thursday I walked into a mess. One of my patients was receiving hefty blood transfusions and had a surgical dressing that was saturated despite being reinforced, changed, and reinforced again. The second patient had dimentia and was agitated all night and needed to be transferred to a stretcher, then it was discovered that many of his meds had duplicate/conflicting orders that needed to be organized. My third patient’s meds (about a dozen meds) had been ordered, but not scheduled, so the pharmacy hadn’t sent any up to the unit, and my fourth patient was having pain control issues that hadn’t been resolved.

I just took a deep breath, dug in, and organized! I worked my ass off and by noon, everything was fixed, solved, and settled. I was very proud of myself for taking on an enormous chunk of chaos and fixed it!

Friday, I was sure it would be a good day. I had done so well organizing my patients care the day before that I knew it would be a much better day….wrong.

It started out by finding the dimentia patient on the floor, flat on his back, and covered in blood from all the IVs that were pulled out. He had fallen while trying to get to the bathroom. *deep breath* and called for help! Another patient had a complex discharge that needed to be organized…and on and on and on. Again, I dug in, worked my ass off, and organized everything.

I’m proud of the work I did this week (Sean gives himself a pat on the back).

And now, it’s back to night shifts for two weeks. YAY!

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Why I’ve lost all faith in myfellow nurses
byBETHANN SIVITER
Daily Mail
27 Mar 2007

NEVER had I been so frightened. After two weeks of persistent chest pain, I suddenly found myself lying in a hospital bed at night feeling very, very sick. My pain had become intense and inescapable, cutting through to my back and intensifying every… read more…