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.