What a difference a week makes. This past Sunday at work was infinitely better than the last one. I'm getting better with coordinating my care, managing my tasks and charting ad nauseam in the computer. I'm hanging platelets like it's an ordinary occurrence, which is good because on that floor hanging platelets, blood and electrolyte replacements is routine. I reaccessed and changed the dressing on someone's port yesterday, I'm a slut when it comes to acquiring new nursing skills. I'm slowly finding my groove with having three patients, becoming more familiar with where to find what I need and dealing better with the disorganization that's inherent everywhere. I realistically fantasize that I would be a horrible chief nursing officer when it comes to schmoozing but I would kick ass at the organization part. The highlight of my day was at the very end when a younger patient asked when I'd working again. The mother came out in the hallway a few minutes later and said that the patient told her she was going to miss me until Friday. It brought tears to my eyes and makes every other experience that brings me to tears in a not so rewarding way worth it. It's why I wanted to become a nurse.

So with those kind thoughts in my heart I floated out of the hospital after working thirteen hours Sunday night, totally forgot the Oscars were on and wound up renting Drive, which was horrible. It was cheesy, overly reliant on silence to show it was arty and weirdly anachronistic in an eighties sort of way. Albert Brooks cannot play a bad guy to save his life, his voice just doesn't work that way, it belies his sweetness, even when he's cursing. He'll forever be Marlin, Nemo's dad, in my mind. Or I'll think of how much I loved him in Broadcast News and Defending Your Life. He's meant to play lovably, self-deprecating, funny men. His DNA has typecast him. Ryan Gosling might be hot but his voice reminds me of a weasel. He sounds like trouble. Owen Wilson is a hot mess but that man's voice is like honey, his voice could make you overlook how deeply troubled he is. I'd rather listen to him than the weasel any day. But if I had my druthers the voice I'd be listening to daily would be British. Hugh Laurie, Ralph Fiennes, Tim Roth - I'd take any or all of them to listen to. The one real bummer in my quotidian exercise routine is the man at the gym who made me goofy is MIA. He hasn't been there since November. I can't tell you how sad it makes me every time I note his absence. It's not like I knew him but damn he gave me a nice visual reprieve during the hour and a half of torture I put my body through. Hopefully he's hibernating and will be back come April, he'd still be nice to steal glances at ten or twenty pounds heavier. Just come back to the gym hot Tim Roth/Eddie Munster man.

unblock me

I don't have a smart phone, an ipad or anything else that would let me play unblock me at the addictive level I'd like, which would be where every need except those basic physiological ones gets shelved, and even those can be put on hold. There's no moderation for me with unblock me. So it's probably for the best that I lack fancy new gadgets that would let me download this 99 cent version of spatial relations crack. It's such a simple game, just move the yellowish blocks around until you clear a path for the red block to go through the opening on the right, and when that red block passes through there's a little trill of victory music that gives you just the dopamine squirt you need to get hooked. It's like a Pavlovian response for geeks. You can't stop with just one game, or ten. At least I can't.

It's funny though, how much unblock me mirrors my life. Puzzling out how to get through nursing school, then boards, then finding a job. I'd get the dopamine rush of success, I wish I could hear the accompanying music trill when I accomplished these goals, but then I'm faced with another puzzle to get through. I mean I love brainteasers so I guess in some ways I should be glad that this is what life throws my way. But another part of me, the rather sizable middle aged, single mom of two in a very new and stressful job part of me, just wants the path to be easier. It's exhausting trying so hard, all the time. And I feel so fucking alone at times.


So is it any wonder that after 13 hours at work, where I've sat down and relaxed for oh, all of fifteen minutes, my mind is focused on eating something, anything, everything to obliterate the day and then succumb to a food coma until I have to get up at 5:00 and start the day again. I need balance in my life and I've got to puzzle out a way to find some on the days I'm not working, and put little bits and pieces of kindness into my life on the days I am working. At it's worst, floor nursing seems like a career that's focused on subverting your basic physiological needs and that just doesn't seem good to me. Is it good for anyone to do that to themselves?

Can I say that Sunday was a horrible day at work for me. I'd been doing so well. The other nurses have gone out of their way to say just how well I've been doing, which honestly made me feel like they're going over the top with their praise because I find fault in every little misstep I do, I'm so slow and awkward with my skills, and magnify to alarming proportions. But the charge nurse joked 'are you going to be done with orientation in a couple weeks?' because I seem to be picking things up so quickly. To be fair, my patients have all been very easy and my schooling helped enormously in picking up the computer documentation system, even if I find way too many problems with it. But Sunday I had a patient from Hell. I usually can do a good job at not taking things personally. And I had asked for a patient that was more of a challenge, but I wanted one where I could increase my nursing skills (hanging blood, platelets, coordinating lots of different medications) this patient was a psychosocial nightmare and that was not the challenge I was looking for. The patient had nothing good to say about what I did, in fact the patient did an ongoing passive aggressive dialogue whenever I was in there about just how incompetent I was. Any confidence I had in how I was doing was gone by five o'clock Sunday when I left the patient's room after getting vitals. I said nothing the whole time I was in the patient's room and being told of my many failings, but as soon as I left and walked down the hall I wound up bawling. The other nurses were extraordinarily nice, telling me not to take it personally and stressing how hard this floor is to work on, and the charge nurse that day told me she thought I was experienced because I've been doing such a good job. I know they meant well, I just felt horrible, like I couldn't do anything right. It was a day that made me question my deciding to get into the field.

I keep having dreams where my house is a terrible mess, all my time and money spent on something that's falling apart on me. The walls are crumbling, the foundation sagging. In lieu of the nursing nightmares and forgetting my kids somewhere this is my reprieve, a house of usher collapsing under the weight of my worries. I just want something solid that I can count on but more and more I think it's foolish to assume that such a thing exists. And this puts me in a very uncomfortable position, it's similar to where somebody does something that makes you very mad at them, but you're clearly aware that that anger is more self directed because they've done something that you hate in yourself. I don't like being in this space. Well February is almost over with, hopefully the self discontent will abate and I'll feel more in control moving around the blocks in this latest puzzle I'm faced with.

week 1

Hello. I will try to post more than monthly in the future. I've been hunkered down since Christmas because I don't like winter, even when it's a mild winter that sees my gas bill at an astoundingly low rate. And February is my least favorite month of the year, thank God it's the shortest one even if we get an extra day this year. January through early April is usually a hellish stretch for me. I just try to keep my head down, indulge in chocolate at an alarming rate, exercise and hopefully get out on the other side by May.

So I started work, last week was my first week on the floor at the Bone Marrow/Transplant unit. And I made it through the week without causing a sentinel event. I'm only partially joking about this. Becoming a nurse has put my borderline OCD into a most likely diagnosable OCD, at least when it comes to medications and making sure I don't make a mistake. I have nightmares about this stuff. Troubling dreams with syringes and me not following aseptic technique, with me doing stuff I'd never do in reality. It's the sister nightmare to my parenting nightmares where I forget the children at malls, I wake up from those dreams wanting to scrub the memories away a la Silkwood. This might seem crazy to those not in the profession. Hell I'm sure it might seem crazy to plenty of those in healthcare. But there is so much in the real world of healthcare that falls way outside the realm of what I was taught, and the utopian healthcare world that you come across on the NCLEX exam. And it's hard for me bridging that divide. Knowing what I don't need to worry about and what I cannot put aside. I am a cautious person, anyone that knows me well would attest to this. Having children put my cautious nature into overdrive and nursing school, I didn't realize I could become more of a cautious freak but I did.

I joked with my preceptor (a nurse on the floor that I shadow for 12 weeks during my orientation to the unit, she's amazing) that the patient population on this floor is like the NCLEX come to life. Almost every patient I've had has a central line, most are on neutropenic diets and due to their being so immunosuppressed precautions are instituted to prevent them from acquiring an infection, which means I can't use my kick ass littman stethoscope but, instead must rely on the fisher price equivalent that's placed in every patient's room and absolutely sucks when it comes to auscultation. Hanging platelets and blood is an everyday occurrence and once I receive training in March and April I'll be able to hang chemo. The learning curve from nursing student into actually being a practicing nurse, especially in this unit, is sort of astronomical. But that's okay because the two main reasons I got into nursing are that I wanted to help people and that I wanted to be in a job where I was constantly learning and this field more than meets both of those reasons. I just tend to read up a lot on my days off trying to familiarize myself more with leukemia and lymphoma, the medicines, pertinent lab tests and complications for these patients.

There are two roadblocks I've noticed this first week, and it's not job specific, it's endemic to healthcare. The first is gossip. I don't know if nursing is more gossipy than other professions but I just don't have any interest in participating in it. I don't want to act sanctimonious about it I just want to be nice and professional with everyone and not get involved with the griping about certain patients or other nurses, it's just not my thing. I get that many people do this to relieve stress in a field that is incredibly stressful but to me it's enervating so I want to glide past it without seeming bitchy. The second roadblock is the computer system, which is a travesty. I'm all for a computerized documentation system that is easy, efficient and helps healthcare workers do their job better. But I've yet to come across a system where I don't find problems that I think can result in errors and could potentially harm the patient. In addition to my worrying, becoming a nurse has put my compulsion to fix things into overdrive as well. I always look at things on the floor and find all the problems and think there must be an easier, intuitive way to make the nurse's job at dispensing medication and documenting assessments idiot proof. And I don't say this because nurses are idiots and need to take it easy. More that they're overwhelmed with tasks throughout their shift and if you can make the documentation and medication administration easy you just might free up the registered nurse to do what she's been trained for, use her critical thinking to keep on top of the patients care. Some nurses can balance all of this but I can't help but think that others sort of put the critical thinking on hold and become excellent task managers but then don't have the time to notice the early signs of a patient decompensating until it's too late.

I'll try to post about non nursing things in the future or maybe I can fill you in on something more vapid related to nursing, like my quest for fashionable scrubs. I know this is stuff that will probably put most people to sleep, or at least make them promptly click their back arrow button. But I'm pretty passionate about medicine. And I have hope that I can get to a position where I can make things better.