Update.

Sometime I have a few shifts in a row where I head home just buzzing and happy and excited.  Vickey reminds me that not every shift is like this and I know this, but sometimes you have to slog through the tough ones to get the ones that spin together in a way that is satisfying.  A good shift is when the work is steady, but challenging and you have friends working the rooms ahead of you and behind you to help you out when you need it.  When you have time to go on walks with all your surgical patients.  During the night before one of my shifts, a patient had filed a complaint with the management of the hospital – it was enough to go to the customer relations department which is past the authority of my director.  Anyways, I had grabbed the assignment sheet at 6:30 am and was just reading about my patients for the day and didn’t know anything about this high level complaint until 7 am when the morning huddle convened to do the shift change when I realized that they had assigned this particular patient to me.  Nursing-wise, this patient was a piece of cake. I was kind of flattered they trusted me enough to re-right this patient’s experience.  And I mostly did, I think.  It’s kind of fun for me to do this.  On the same shift, I also had a patient who was admitted into my care who was not stable enough to be on our unit.  So I had to manage a transfer to the ICU, but this is less fun for me.  I like my unit because even though everyone is sick, no one is really, really sick. And because no one is really, really sick, there is nothing in my medication dispenser that can really kill a person, which is what I like when I’m learning to be a nurse.  From Nurse Jackie – The only thing I want to do besides help people is not kill them.   On my unit, a patient’s vital signs need to be stable over the course of 4-8 hours.  So if a person needs vitals checked at least hourly, I can’t take care of them.  I don’t have the medications necessary to stabilize them (because our pyxis doesn’t have medications that can kill people, it also – as a corollary, doesn’t have medications that can really save you if you are really, really sick), I don’t have the expertise, I don’t have the monitoring capabilities.  So the transfer to ICU still takes a couple of hours, so I’m running around trying to take vitals every 30 minutes, calling the doctors both on our unit and in ICU to coordinate what care I can do for them.

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I’m starting to tell the doctors what I want for my patients.  They are starting to ask me what the patients need.

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I’m still tired.  I’m looking forward to working less.