Saturday, April 6, 2013

sunsets, dog walks and a break from work...

 cruised out to point worzonof for the sunset tonight.  it happens close to 9pm now.  just finished my stretch of days and i was a wee bit busy the last two nights.
that is sleeping lady above.  that mountain always looks so peaceful, especially during a sunset.
 floated to the pediatrics icu the first night, which was good.  nice to be on familiar ground after being sick and still hacking and coughing.  work is so dry i'm not sure it's the best place for me, but i got through it.  a few friends sent some lovely notes which arrived this latter part of the week.  kind words are always appreciated!!
i also enjoyed not having the sickest of the sick in peds icu this week.  kinda a chill night for me.  the next two nights totally made up for that i'm sure!
 i landed in the emergency room the next night.  i was supposed to have 4 nights of orientation, but that wasn't to be.  i was out on my own. part of me figures this is some sort of punishment for calling out sick.  i'm always expecting some sort of retribution for calling out sick not matter how valid the reason was.  they started out by giving me hold patients...those are patients that are going to be admitted to the hospital but that have not been assigned a room.  so i got loaded up and got report.  i was told i needed to start a new iv in one room and start blood in another.  so off i went. i was working with a wonderful and experienced nurse back where i was, esther...she's one of those amazing people who always more back to this world than she ever takes.  she collects expired and unused medical items that can't be used in our country but that can be used in other parts of the world or even in vet clinics.  just awesome!!  i'm so lazy compared to people like this.
let her know that i was taken off orientation early and she and the other girl i was working around helped.  i knew i could get through it with their help.  only one of my patients had a room assigned.  this soon changed and by 8 or 8:15 all my patients suddenly had rooms to transfer to.  as i started the process of getting them out one by one the charge comes to me and starts busting my chops because i haven't moved them all out yet.   she was really going at me....i was just thinking, "why is this person being so mean to me?".
 luckily, i am quite capable of holding my own.  i informed her that i was doing my best and had only received 2 nights orientation.  i think that settled her down though i know she went after the shift coordinators for sending her such and inept and untrained staff member.  i rapidly gave report and ditched all my patients, getting my arse reamed from various floor nurses for this and that.  i had little hope of any improvement in my night.
 as soon as they were out though i realized that the place wasn't even that busy and between the 3 nurses, we each just had one patient...still not sure what the rush was?  of course, since then i have heard from several folks that this particular charge nurse has a history of going off on people.  i shifted to the main section of the er and helped a few nurses with their patients and then was moved to another area and had my own load.  worked with another nice co-worker and the rest of the night went quite smoothly. everyone was helpful and nice.  in the morning the charge nurse was all nice to me and said i could come back anytime.
 the oncoming charge is someone i worked with in ketchikan...this is a small state.  she's super nice.  she mentioned that the night charge had told her she thought she had ticked me off. always better to hold your own with people like that i think.  it's just a matter of getting used to the flow and where stuff is.
 had my first night on peat...which is a rapid response team.  the peat nurse, looks up all the patients who have been admitted within 24 hours and the patients who have been transferred out of the adult icu within 24 hours and follows up on them.  the peat nurse also carries a regular phone that any nurse can call and ask questions or run stuff past you as a critical care nurse.  i know i won't always have the answers for them.  you also carry a pager which alerts you to vital signs that are out of range and can be used by anyone to signal a patient that seems to be going down the tubes as it were.  i make rounds and make myself available and try to check in with nurses about any issues or concerns they may have and also check on those new patients.  i feel like i'm responsible for the entire hospital since i'm still so new at this and it feels very stressful to me.  i don't think i like sitting around waiting for terrible things to happen and i certainly feel like i have a pager phobia begining.  those things are loud and set you off.
 more controversy.  at 1 am the adult icu was getting a new admit and had no nurse to cover it.  they had an supervisor (acm) on was felt that i should be pulled from peat and sent to acc.  i know there was a bit of a battle going on over the whole situation. i think they try to avoid pulling the peat nurse unless we drum up a patient in house that can't be staffed for.
 anyway, i go where i'm told and generally do not wish to get into anything so i went to the adult icu at 1 am and got the first of my two admits from the er.  the charge nurse took the peat beeper and i kept the peat phone.  acc just used my peat phone as my phone as well so i just started answering, "acc and peat, betsy speaking".  i had only had like one call before 0100 but after i started getting my admits the phone calls picked up. i think i had 5-6 total for the night.  so between assisting with lines and spinals and starting blood products and admitting two patients i took calls from around the hospital and tried to help and advise nurses. i sent the charge up to one patient who i thought sounded like had gone into afib ( a heart rhythm change).
 somewhere in there the supervisor from the icu showed up.  i asked her if she was going to take report on my patients and if i would return to peat duties and she said no she was just going to help out.  the pager went off for my first official peat call.  the charge brought it to me and it said something about labor and delivery. we will go anywhere but we rarely go of course, that is exactly where we were needed on this my first day on my own. icu nurses don't like the whole baby delivery process.  the supervisor from icu then was trying to get me to now go to this peat call.  i have no desire to start some precedent where i take icu patients and run off to do peat calls around the hospital in addition.  i made her go. don't get me wrong, i actually really like this supervisor.  it was just kinda funny how that all worked out.  i had to kinda chuckle to myself because i had totally predicted this scenario to the house coordinator nurse hours before.
 hopefully though, this crazy night will help me be less stressed over this peat role.  i mean if i can manage 2 intensive care unit admits while simultaneously managing the peat tasks...well, i may survive it. not sure i love it yet though. i have 3 nights on peat next week so we shall see how it goes.
 in addition to all the madness last night when i got to work i found that i had totally forgotten to load my pockets with the trinkets we nurses like to carry. i also forgot my pens and my badge.  hard to survive with out that dang badge.  the shift coordinators were sweet and let me book home and get my badge.  it was a 20 min round trip. i consider it my only break that night....
 blossom at point worzonof.
 i'm looking forward to a good nights rest tonight and several days off.
 i think this is laika chilling in the front seat.  love when dogs sit in the drivers seat.
 the first day between shifts i didn't sleep well so i rested a lot and no walk.  the next day i took the girls out to north bivouac and did a little loop out there.  i was so happy to get home in the mornings and take my strong cough medicine.  robitussin doesn't do crap to stop my coughing.  had a great crew in the icu so we had fun in addition to getting everything and everyone taken care of.
 reflections on the snow. always love those.
 pogi, my sweet kitty.
 today i took blossom and we walked campbell airstrip and looped around the main trail.  rio stayed home.  she was limping a bit on her left shoulder the day before after her walk so she got pain meds and rest today.  she seemed to be walking fine for me today.
 a few more from tonights sunset. these are actually from my little camera snapped out the window of the car as i was driving to point worzonof.  there is a crack across the windshield so i had to avoid that in my photo. hoping to wait til after break up to change that out.
 this one is also out the window closer to the end of the road on northern lights blvd.
 got my taxes done today...yippee!!  get a nice chunk of change back.  just great to have that done and crossed off the list.
 the rest of these are from tuesdays walk.  amy and lena joined me with their pups.  it was another beautiful day out there.  the dogs are all had a great time.  amy's dogs found the creek.
 ekko was holding the tennis ball hostage.  blossom patiently awaits it's release.
 watched part of a katie couric show the other day with marie osmond.  she talked a bit about her own issues with depression and i do understand some of that.  how it seems like your brain tells you how terrible you are and that nobody likes you.  i tend to call in episodes of melancholy.  your brain really can play tricks on you and bring you down. fortunately mine usually doesn't last that long.  i can see how people who battle constantly with depressive disorders eventually begin to believe that voice in their heads and all the negative things that are being pressed into you.
 at one point couric asked her about her daughter. apparently one of her daughters has come out as gay.  kouric asked about how she felt about the mormon church's stance on homosexuality and gay marriage.  clearly, the mormon church has not been too keen on either of these issues.  osmond totally just talked around the question by smiling and repeating...mormons are christians like everyone else and it's all just about love.  kouric knew there would be no real answer to that one.  strange.
 i never liked the mormon culture in that so many seem to fake like they already  have perfect lives and families.  as a kid i was so fooled by a few families that came off as the ideal family only to discover that they were so far from ideal and i just remember being floored that these perfect lives that i so wanted to emulate and was so wowed by were really just these huge lies.  i can so see that in all the just is so gross to me now...this whole fake perfection act.
 lucy naps away the walk.
 the mutes get rambunctious.  blossom tends to avoid the rougher malemute play.

 boys in the hood...thought these were kinda cool.

guess i shall prepare to turn in for the night.  supposed to snow bunches tomorrow and the next day i think.  we shall see.

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