Thursday, June 16, 2011

bad at blogging

Lilly on her bike being crazy

allan supervising the kids on ride at the mall

two pretty girls.

rainbow cake

the back yard..

It's been at least a week huh? sorry. I have pictures to post in an attempt to make up for that. We had a birthday party for emma and i finally downloaded the pictures but I was goign to do this posting i think it's called 10 on 10 where you take 10 pictures thru the day of things you find beautiful. So in a combination I'm going to post some of my favorite pics that downloaded from the camera since i didn't have time to do the project. I am winding down on my school work and well.. it's killing me. I finished up a paper today. I have to more to write before tuesday. I also have to write a 5-7 page paper for a final worth 20% of my grade for one class and take an exam for the other.. i'm over all of it.! i know i've said it before but i am serious! I am so close to that bsn degree but it wont make a bit of difference at my present job so i don't feel the big push for it. Any BSN nurses out there want to give me some encouragement or tell me why it's so much better than a plain old associates degree.. seriously need some motivation!!! Talked to my friend that works at the douglas hospital back in wyoming. She tells me the ratio for nurse/patient is no more than 6 but that she has never had 6 it's almost always 4 or 5 patients to one nurse. That sounds dreamy. Do i sound sad.. lol Our census at work has got down to 33 patients i think. This may sound so small to you guys but i had half of them the other day and let me tell you 16 patients was like a vacation for me. That is what sounds sad. I know hospital nurses have more critical patients generally but if you saw the patients that we have been accepting you would think they need to be at a hospital. I can't believe they are calling some of these patients rehab patients.. I mean some seem to be holding on to life by a thread and we are suppose to be rehabilitating them? I am thankful for all the inappropriate patients because without them i would not have a job but I just don't know how this is justified. It's sad and overwhelming all at the same time. But i decided that i really like my job today because i turned down another interview. That's 2.. yeah. i mean i pick my own schedule just about and i can text the staffing lady and ask for a day off and she gets me it everytime no paperwork or questions asked. I work 2 or 3 days a week and i get paid at least 5 more dollars an hour than the hospital nurses just starting out so.. really what's to complain about? I shouldn't complain at all right? right.. So today i decided i really like my job. Yes there are things to complain or argue about but in the end i really love it and i'm not going anywhere(so long as the continue to love me and keep me around haha)! its still a good learning enviroment. I have learned about wound vacs, feeding tubes ( peg and ng), ivs, blood draws, wound care, breathing treatments, a ton of medication stuff, how to take an order from a doctor that speaks about 1000 words a minute and from one that writes so bad that you can't make out your own name if he wrote it down.. Im sure all these skills will come in handy. I have to say i'm seldom really uncomfortable doing much as a nurse. I mean i can put in a catheter and talk to you about what i had for lunch today. But the last day i worked i had my first truely uncomfortable moment. I talked to a family trying to brace them that their love one might not make it. I did not say it like that and it took me a while to get it out. I first approached the subject in curiousity. They had asked me a ton of questions about the patients condition and it sounded like they were expecting the patient to get up and do cartwheels. I was a bit confused because i thoguht someone had talked to them and told them that the pt was declining. Someone like a social worker, doctor, director of nursing.. i don't know. someone other than this little nurse. I wasn't sure what to say so I simply asked them what their expectations were for their loved one while they were here. they said " to get better" i don't want to break any hippa laws but i want to share my story. This patient had so many things wrong and had came to the point where they weren't eating or drinking much of anything. I had been putting sips of water in their mouth by holding a straw the way you would with a small child putting one finger over the end of the straw then letting go. I contemplated the family's words for a moment and thought are they looking at the same person i am. I'm not trying to be blunt but in my eye's i saw a dying person and thought this pt will never full recover and the life pt has left wont have much quality to it wouldn't it be better if the pt passed? Do Not resusitate or DNR orders are a hard topic. This pt was a full code and I can not imagine having to do CPR on a pt that was so bad off. So i excused myself from their room taking the cowards way out i suppose. WEll i went and thought about what to say got my nerve back up realized that while i was looking a the pt thru nursing eyes i did not see the same person they saw. So i answered my same question that NO WE WERENT LOOKING AT THE SAME PERSON>.. So i decided that this family needed to start thinking about what the road ahead would be like and where they needed to go but to say hey you need to just let your loved one die.. no i could not say that. So in my uncomfortable moment i went back to the room mustered up the courage and said.. "your loved one has stopped eating and stopped drinking. I am not a doctor, I have no idea what the doctors thoughts are but as her nurse i want to be completely honest with you. When i have seen other patients like this they become dehydrated, this means they need to get iv's ( because the patients skin was very broken down i told them that couldn't be done at our facility) I also said even if we got an IV in we would still need to get food in which would mean a feeding tube. I told them they needed to start thinking about if this is something that she would have wanted and if this was something they would want to do for her. I told them that this was the easier part of the road ahead and that there would be multiple harder questions than just this." I would love to be able to tell everyone that rainbows are abundant and things will always get better and patients will never die but that isn't the truth and I pretty much decided that i would be a truthful nurse. I can't be a perfect one no one is but i can afford you the truth. Am i brutal no.. but i do not steer people in the wrong direction or blow smoke up their butts. If you ask me I will tell you my professional opinion.. I will tell you that i am not the doctor and don't make choices concerning your healthcare but If there is something my patients need I work hard to gt it for them. I constantly advocate for them and Im honest even when it's uncomfortable and even when I make a mistake. I made a med error and i could have hid it a while back. It was awful and thank god no one got hurt! The first person i told (even though it could of been a lawsuit or whatever) was the patient. I believe people have a right to be informed of their healthcare. The patient was not at all worried and said i was the best nurse she had while she was there and that if i told her all was fine then she wasn't worried. All was fine, i still did an incident report and she was so concerned that i would get in trouble she kept bragging to my bosses about me. LOL>> I did not get in trouble i learned from it and they know that i am honest even when it counts. (lets face it it's easy to be honest when it doesn't matter.) ;-) Wow I got on a weird random story tonight. Guess it's on my mind. Here are some more pictures as promised from wayyyyyyy up there at the top of this post. check out the photosite for more of them. good night! lilly making fast friends at baskin robins..
fish tacos remind me of summer
and the flag makes it seem like a patriotic summer always. fourth of july is around the corner.


Kerri said...

Wow, did you make the rainbow cake? It looks awesome! The colors are so bright. And, your backyard looks like a dream to me!
It's nice that you recognize that you have it good at your current job. Nurses work so's one job I know I could never do. I hate the smell in hospitals and doctor offices.

your friends the keyes said...

Keri thanks for the comment. No I didn't make the cake. Emma is my step daughter so we had the party here but her mom made the cake. It was really neat. It tasted wonderful too but I kept expecting my tongue to be blue or green.. lol

Grace said...

Hi Keri. Thanks for stopping by my blog. To answer your question- right now I just finished up with my first semester of nursing school and while I'd love to just get my Associates, I'm totally going for a Bachelors. I just read that to you it doesn't feel like it'll make a difference where you work, but while it may not NOW who knows down the road. The nurses that I've talked to have told me that they wished they wold have just continued on to their BSN. So I mean, I don't know, it may open some more opportunities in the future.

I'm really glad that you were honest with your pt's family members. That's one of the things that I'm not looking forward as a nurse, to letting the patient or their family know that they will probably not make it and dealing with all those emotions. You did good though. I'm excited to read more about your experiences, because I feel like I learn a lot from others as well.

Well have a great day!!!

The Mason Bunch said...

I love the pictures. Looks like the kids are having a wonderful start to Summer vacation. Happy Birthday Emma! Y'all have a great Summer. Don't work too hard.