so nursing isn't just needed in the badlands of Philadelphia. Its a world wide thing. As sure as anything, there will always be a need for nursing and medical help.
I've mentioned before that my wife and I are both ER nurses. I've also noted that we work together currently. We have just been confirmed on a medical missions trip to El Salvador this September. Our team is comprised of mostly nurses, but also a number of dental hygenists, a dentist, a couple translators, and a pastor. Things such as these are great. The ability to have a knowledge and skill, and then the opportunity and want to offer them to those in desperate need. The people we will serve are those without insurance, or even access to medical care. We shall travel to 3 smaller cities of El Salvador where the need is great. We expect to take 100 per day and accept this to be a modest number. This will be the first of many medical missions trips like this to El Salvador. The team is going to provide medical care as well as teachings and witnessing of the Lord's words and works. We travel abroad under the wing of Calvary Chapel of Philadelphia's head pastor Joe Focht. And under the guidance of a Calvary Chapel sister church we will put our skills to good use.
That is the story, and this is the pitch...trips such as these do not come easy for most. It is mentally, physically, and financially straining. My wife and I are both using our vacation time and many favors of our coworkers to take the time off and spend it helping those in need. We first ask for your prayers and thoughts. Second we ask for a monetary donation and any size or portion. If a monetary donation is not feasible, we do have basic needs for equipment such as otoscopes, thermometers, tongue blades, gauze, medical tape, surgical equipment, sphygmomanometers or blood pressure cuffs, stethoscopes, alcohol pads, etc.
Please contact me with any questions @ vernon.kalugdan@gmail.com
You can also directly mail or drop off your donations to the church @
Calvary Chapel of Philadelphia
13500 Philmont Ave
Phila Pa 19116
Please "c/o" the donations with "Vernon Kalugdan/El Salvador Medical Missions Trip"
The below button will take you to a Paypal donation form specifically tailored to our Medical Mission Trip to El Salvador. You may make ANY size donation, and anything you offer is greatly appreciated.
Keep your records as they will be your proof for tax deduction purposes.
Tuesday, August 18, 2009
Tuesday, June 2, 2009
and now i have.....
GERD. my fellow nurses, and especially emergency nurses, will agree that our eating habits are not the greatest, to put it lightly. in a busy er, on a busy day we are lucky to eat at all. and for that split second that we can, we shove anything and everything in our mouth and get back to work.
its just what we've become accustomed to. now i've been in the er since 02. and i've recently become overtaken by symptoms indicative of GERD. well, my best friend is an ER attending, assistant director of a local. and he flat out says, 'im sure you have GERD'.
that statement took me for a little while. its true. its the lifestyle we chose. just like the residents making no money, working all hours, getting little sleep, and just getting by. for me, its the lifestyle i chose. i didn't realize the repercussions that i'd be facing. GERD is definitely not the worst, but it does suck.
a wonderful little thing that is purple with yellow lines. Nexium. well, its been said and i guess its true...i'll be on this forever. i would laugh at my wife, she's not a pill taker, and with certain conditions come everyday pills. well, i've now joined the club.
...where's the party
its just what we've become accustomed to. now i've been in the er since 02. and i've recently become overtaken by symptoms indicative of GERD. well, my best friend is an ER attending, assistant director of a local. and he flat out says, 'im sure you have GERD'.
that statement took me for a little while. its true. its the lifestyle we chose. just like the residents making no money, working all hours, getting little sleep, and just getting by. for me, its the lifestyle i chose. i didn't realize the repercussions that i'd be facing. GERD is definitely not the worst, but it does suck.
a wonderful little thing that is purple with yellow lines. Nexium. well, its been said and i guess its true...i'll be on this forever. i would laugh at my wife, she's not a pill taker, and with certain conditions come everyday pills. well, i've now joined the club.
...where's the party
Monday, May 25, 2009
time off...to recuperate and reflect
its a wonderful thing to have time away from work. being a nurse you have such flexibility. where else would you get full time benefits, work 3 days a week, and somehow get 6 days off in a row???
the other day i had a conversation with an irate resident. she had been snapping at co-workers and even a patient here and there all day. when it came down to it i knew that this wasn't her normal self. well, come to find out she had basically been working everyday for multiple weeks and it was just getting to her.
unfortunately, this is the field you chose, and this is the route you must take. i get asked by many, whether i am in training or whether this is a stepping stone to becoming a doctor. no, i do not want to be a doctor. i see what they go through, and the great things they do. but i enjoy being able to sit with a patient here and there. just talk, and sometimes get to know them. being able to take the time on a slower day and make sure they understand the medications, or their disease process. its the interaction time that you lack being a doctor. and for right now, i enjoy that.
every once in awhile you'll get a patient that is really nice. a sweet little old lady or a nice gentleman. and you just get the notion that they want some company. i don't mind it and actually take pleasure in interacting with my patients on a more personable level.
just the other day i met a very nice man. he had a curious accent. John had come in for bilateral lower extremity pitting edema and shortness of breath. he was not a young pup, but not old. pushing 60s. he was placed in my assignment in the corner. kind of tucked away not to be seen or disturbed. but i frequently make my way there to keep an eye on the area and its revolving inhabitants.
John had complaints of swelling and shortness of breath yet looked to be as happy as could be. other than being alone. every time i had entered or walked by he would start a little chat with me. now this wasn't a slow day, but i could definitely take a few moments here and there, scattered, and talk with him. i learned his accent was from Tanzania and that he had planned to return home. 'when you're older you wonder how it is back home, the family, the land, the food' he said. we got to talking about culture, and my background, and how his interactions with another hospital weren't as pleasant as they had been here.
interestingly enough it is heard through the grapevine, that the other facility is known for its innovation and money and technology. however, i hear from too many that the personability is lacking there. the homely, humble, and plain friendly interactions are not felt there. and yet, because of where my current facility is located, the neighborhoods it serves are less endowed, and yet they are more appreciative, on the whole. of course you get those that just nothing will make them happy. but its my opinion that the those that have less, appreciate less, and the more you give, the more they appreciate.
now my newly befriended patient, John, was actually discharged much the opposite of many of our staff's opinions. after review with the md, it seemed that with xrays, lab work, ecg, and ultrasound that there was no acute life threatening cause for the symptoms and he was able to be released to follow up. we made sure he understood followup care and had case management reiterate this info to him. and i did the same before i let him go adding in some 'what ifs' of my own. he was so pleased to not only have such a pleasant time in a questionable moment and a lonely place in his life, but also to be able to go home! he continually asked if he could talk to management on our staff's behalf. but i assured him that that is not why he was treated so nicely. and i am sure that with my team i had that day, it was not.
some days, you just love doing what you do. and others...well, let's leave that for another blog entry shall we? :)
the other day i had a conversation with an irate resident. she had been snapping at co-workers and even a patient here and there all day. when it came down to it i knew that this wasn't her normal self. well, come to find out she had basically been working everyday for multiple weeks and it was just getting to her.
unfortunately, this is the field you chose, and this is the route you must take. i get asked by many, whether i am in training or whether this is a stepping stone to becoming a doctor. no, i do not want to be a doctor. i see what they go through, and the great things they do. but i enjoy being able to sit with a patient here and there. just talk, and sometimes get to know them. being able to take the time on a slower day and make sure they understand the medications, or their disease process. its the interaction time that you lack being a doctor. and for right now, i enjoy that.
every once in awhile you'll get a patient that is really nice. a sweet little old lady or a nice gentleman. and you just get the notion that they want some company. i don't mind it and actually take pleasure in interacting with my patients on a more personable level.
just the other day i met a very nice man. he had a curious accent. John had come in for bilateral lower extremity pitting edema and shortness of breath. he was not a young pup, but not old. pushing 60s. he was placed in my assignment in the corner. kind of tucked away not to be seen or disturbed. but i frequently make my way there to keep an eye on the area and its revolving inhabitants.
John had complaints of swelling and shortness of breath yet looked to be as happy as could be. other than being alone. every time i had entered or walked by he would start a little chat with me. now this wasn't a slow day, but i could definitely take a few moments here and there, scattered, and talk with him. i learned his accent was from Tanzania and that he had planned to return home. 'when you're older you wonder how it is back home, the family, the land, the food' he said. we got to talking about culture, and my background, and how his interactions with another hospital weren't as pleasant as they had been here.
interestingly enough it is heard through the grapevine, that the other facility is known for its innovation and money and technology. however, i hear from too many that the personability is lacking there. the homely, humble, and plain friendly interactions are not felt there. and yet, because of where my current facility is located, the neighborhoods it serves are less endowed, and yet they are more appreciative, on the whole. of course you get those that just nothing will make them happy. but its my opinion that the those that have less, appreciate less, and the more you give, the more they appreciate.
now my newly befriended patient, John, was actually discharged much the opposite of many of our staff's opinions. after review with the md, it seemed that with xrays, lab work, ecg, and ultrasound that there was no acute life threatening cause for the symptoms and he was able to be released to follow up. we made sure he understood followup care and had case management reiterate this info to him. and i did the same before i let him go adding in some 'what ifs' of my own. he was so pleased to not only have such a pleasant time in a questionable moment and a lonely place in his life, but also to be able to go home! he continually asked if he could talk to management on our staff's behalf. but i assured him that that is not why he was treated so nicely. and i am sure that with my team i had that day, it was not.
some days, you just love doing what you do. and others...well, let's leave that for another blog entry shall we? :)
Wednesday, May 13, 2009
second jobs
so i started another job, a second job at a much farther community hospital. it is situated in a not so nice neighborhood and is about 1.25 hrs from my home on a bad day of traffic.
its layout and operations is basically like my first hospital. so im a bit familiar with some of their ways of care. i got 3 days of orientation and then im off and set free. fine with me, i just need to know their system since its all paper, no computers and very very disorganized. even the staff their say its one big cluster f***. but many of them love it and for those that have been there a while i can see why. you have some that act like family. and like any other hospital you have a Jane or a John or maybe even a few of each that think they are God and that their poop don't stink.
what is it about these people? why do they think they are in charge of the world and must make you feel lowly. why must you publicly demean others, in front of their peers, AND patients no less.
well at this facility there are 2 Janes and 1 John that i've met so far. the Janes have much seniority at this facility and believe me, they pull it and shove it. tensions rise on many occasions and its not professional in the least. now im not the perfect professional mannered nurse either, but i do know there are limits. even my fellow orientees had run ins with one of the Janes.
during orientation it was mentioned that 'we have our oddities just like any other hospital' by the staffing lady. 'we are pretty lenient with things, you get your attitudes and your fowl language, but we do not tolerate lateness.'
um....excuse me? lateness is your priority? ok so i can curse at someone but i can't be 2 minutes late?
well, don't you know, my first day in the er...not even 5 minutes into the shift was there a code. ok, so i've been in so many codes i can't remember nor do i wish to. there is a team and we follow a team leader. who's that? the physician. sweet deal right? think again.
this was the worst run code EVER. i've seen bad codes, this tops them all. and its not just this code. the end of the day was topped off with another code which again was ran poorly. yelling and cursing during the code and super unprofessional words actions and attitudes to and from everyone.
i was appalled.
im new fish and its not my place to retrain the world. but i made my opinions clear to a select few. whether anything comes of it, who knows. right now, its a job, its money, its time. i will practice to my ability and make sure i do no less and no more. i can see that a place like this will only give me experiences that i myself seek into. that is, i will have more time honing my skills and thought processes, time management, people skills, disease process, differentials, etc.
im taking a positive spin on a negative place.
this said, i do actually not hate this place. there are many people that i work with there and i do in fact like them. however i do not see them staying long, as the turn over is quite high. 10 er staff hired during my orientation says something about a place.
and oddly enough, i've seen a number of indigent yet super appreciative patients. event he simplest acts of kindness are more than they've seen in some time, and they let you know it. the smiles and looks and the kind words. im impressed that in a place where the staff might not be so nice, the people it serves are quite the opposite. definitely not expected.
needless to say though, the drive and money and dealing with such staff isn't worth it.
i am looking, while i do my time, and make my money.
its layout and operations is basically like my first hospital. so im a bit familiar with some of their ways of care. i got 3 days of orientation and then im off and set free. fine with me, i just need to know their system since its all paper, no computers and very very disorganized. even the staff their say its one big cluster f***. but many of them love it and for those that have been there a while i can see why. you have some that act like family. and like any other hospital you have a Jane or a John or maybe even a few of each that think they are God and that their poop don't stink.
what is it about these people? why do they think they are in charge of the world and must make you feel lowly. why must you publicly demean others, in front of their peers, AND patients no less.
well at this facility there are 2 Janes and 1 John that i've met so far. the Janes have much seniority at this facility and believe me, they pull it and shove it. tensions rise on many occasions and its not professional in the least. now im not the perfect professional mannered nurse either, but i do know there are limits. even my fellow orientees had run ins with one of the Janes.
during orientation it was mentioned that 'we have our oddities just like any other hospital' by the staffing lady. 'we are pretty lenient with things, you get your attitudes and your fowl language, but we do not tolerate lateness.'
um....excuse me? lateness is your priority? ok so i can curse at someone but i can't be 2 minutes late?
well, don't you know, my first day in the er...not even 5 minutes into the shift was there a code. ok, so i've been in so many codes i can't remember nor do i wish to. there is a team and we follow a team leader. who's that? the physician. sweet deal right? think again.
this was the worst run code EVER. i've seen bad codes, this tops them all. and its not just this code. the end of the day was topped off with another code which again was ran poorly. yelling and cursing during the code and super unprofessional words actions and attitudes to and from everyone.
i was appalled.
im new fish and its not my place to retrain the world. but i made my opinions clear to a select few. whether anything comes of it, who knows. right now, its a job, its money, its time. i will practice to my ability and make sure i do no less and no more. i can see that a place like this will only give me experiences that i myself seek into. that is, i will have more time honing my skills and thought processes, time management, people skills, disease process, differentials, etc.
im taking a positive spin on a negative place.
this said, i do actually not hate this place. there are many people that i work with there and i do in fact like them. however i do not see them staying long, as the turn over is quite high. 10 er staff hired during my orientation says something about a place.
and oddly enough, i've seen a number of indigent yet super appreciative patients. event he simplest acts of kindness are more than they've seen in some time, and they let you know it. the smiles and looks and the kind words. im impressed that in a place where the staff might not be so nice, the people it serves are quite the opposite. definitely not expected.
needless to say though, the drive and money and dealing with such staff isn't worth it.
i am looking, while i do my time, and make my money.
Saturday, May 2, 2009
preferential treatment
now ok, we all should treat each other well and nicely...as i was told, do unto others as you would have them do to you. a patient had an unsatisfactory interaction with another person today, things escalated and supervisor's were involved...this that and the other you know?
well the patient apparently worked at a local shop, a very popular shop in philadelphia. and the other person made a comment...'you didn't tell me you worked there'.
ok, what difference does it make? you don't treat people nicely because of where they work. you treat them nicely because its nice. really now. etiquette lessons for all please.
i do my best to treat all as i would like to be treated, just as i was taught growing up. but do understand im no saint, and that if you come to me with attitude, i'll do my best to brush it off but you may just get it back. to me respect is earned, and not to be expected. you give, you get. no giving but you expect....good luck with that.
well the patient apparently worked at a local shop, a very popular shop in philadelphia. and the other person made a comment...'you didn't tell me you worked there'.
ok, what difference does it make? you don't treat people nicely because of where they work. you treat them nicely because its nice. really now. etiquette lessons for all please.
i do my best to treat all as i would like to be treated, just as i was taught growing up. but do understand im no saint, and that if you come to me with attitude, i'll do my best to brush it off but you may just get it back. to me respect is earned, and not to be expected. you give, you get. no giving but you expect....good luck with that.
wonderful lady
80 years old lively and up and about. some epigastric pain for a week or so getting worse making her unable to sleep or stay in any one position for too long. Jane was as sweet as could be. i fell in love, she was my cutie. non st elevation mi is what she was having. and during her evaluation she kept smiling, joking, and laughing while putting off the pain and discomfort. it wasn't clear whether she was trending up or down with her troponins so a waiting game had begun. and my lady put up with it quite well.
hadn't been in the hospital for herself since birth. pretty damn good for an 80 year old. makes you think, we get so many people abusing 911. calling for a 'free' ride to the hospital for a belly ache, leg pain, or a chronic pain they've had for years and just ran out of percocets. all while the people that really need the service end up taking septa and having friends drop them off.
this little cutie of mine waiting hours for a friend to bring her in and she didn't fret about anything. she was obviously uncomfortable, and she was very sick. yet beyond all this she was the most pleasant thing ever. i couldn't have asked for a better patient, and i asked her to never come back as a patient. i told her to visit and say hi, but not be on the same side of the conversation as today.
so to you, the patient that needs to scream and yell and complain...how is it that my little 80 year old can take it, but you cannot? i understand pain is to each person's understanding. but Nana can take it, why can't you?
it is an absolute pleasure to have patients such as this Jane.
hadn't been in the hospital for herself since birth. pretty damn good for an 80 year old. makes you think, we get so many people abusing 911. calling for a 'free' ride to the hospital for a belly ache, leg pain, or a chronic pain they've had for years and just ran out of percocets. all while the people that really need the service end up taking septa and having friends drop them off.
this little cutie of mine waiting hours for a friend to bring her in and she didn't fret about anything. she was obviously uncomfortable, and she was very sick. yet beyond all this she was the most pleasant thing ever. i couldn't have asked for a better patient, and i asked her to never come back as a patient. i told her to visit and say hi, but not be on the same side of the conversation as today.
so to you, the patient that needs to scream and yell and complain...how is it that my little 80 year old can take it, but you cannot? i understand pain is to each person's understanding. but Nana can take it, why can't you?
it is an absolute pleasure to have patients such as this Jane.
Tuesday, April 28, 2009
im sick
pt: um, i saw someone that looked mexican and i kinda feel feverish. earlier i vomicked into my mouth a bit. its gettin worser now. i think i gots the swine flu
me: ............
me: ............
Tuesday, April 21, 2009
basic nursing 101
im running around taking care of my patient load and my neighbor nurse's patient load because we have crap going on all over and nurses and doctors are running all over the place. one fun day.
well i take note of a nurse across the way from me change an iv bag. ok routine stuff, nursing 101, right? wrong.
the nurse takes the new bag and spikes it with the old line and lets it continue running. sounds ok, but when you look, and i just got new glasses, the line was full of air.
fully disturbed i had to interject pulling the nurse aside and quietly schooling them. i remember seeing this a few times and i just don't get why it isn't known and understood: air embolisms = bad and maybe death
change your tubing or change and flush it right!!
well i take note of a nurse across the way from me change an iv bag. ok routine stuff, nursing 101, right? wrong.
the nurse takes the new bag and spikes it with the old line and lets it continue running. sounds ok, but when you look, and i just got new glasses, the line was full of air.
fully disturbed i had to interject pulling the nurse aside and quietly schooling them. i remember seeing this a few times and i just don't get why it isn't known and understood: air embolisms = bad and maybe death
change your tubing or change and flush it right!!
nursing school was hard
and for many out there it was even harder to get into a nursing program. for me, not so hard. when i actually put my mind into something and do my due diligence...i actually get what i had wanted. well, in most cases. a great book (one of the few) that very much influenced me in my adult life was one by a young steven k scott entitled 'the richest man who ever lived'. lots of bilical references which i like, and it really opened my eyes and my mind.
there's lots of disappointment in life and we get upset. we get upset over what went wrong or why something didn't go our way. the book highlights those reasons, and the main one goes to the effect that you...me or we, didn't do our due diligence. meaning that we didn't cover all of our bases before we went forward in expecting the positive and correct (for us) outcome.
i've been pretty successful in implementing this into my life. still some holes, but im working on it. and i do see a difference in my personal outlook on life, not only with the way i see things, but also the way they effect me. all in a positive way.
ok ok, a little rant but there's some reference to the main topic there. the story is that i wasn't a good student. i slept in class, right in front of the teacher. i was late, i didn't do all my work. i sucked at school. which is a strong reason i originally dropped out during my first semester in college. i went the, what i thought was, the easy way out and enrolled in something i liked....automotive school. my first day on the job i knew that i couldn't do this all of my life.
i met a very nice man...knocking on 50's, living at home with mom and dad, no girlfriend, wearing suspenders, talking to himself and driving what he called a 'chick magnet'. ok super run on sentence there but if you've read any of my entries from previous you know im about thought, not the process :p anyway, it was to get the point through without interruption....i just couldn't do it. i didn't want to end up like this. don't get me wrong, he was the nicest guy, he'd help you out and stick up for you. he lent me any tool that i needed especially the most important one, his mind. super smart guy, he was, a great technician and probably the best i've known in my 6 professional years of automotive.
anyway, i went right back to college when i saw this guy and boy was i motivated. motivation or not i didn't have the best starting grounds. my gpa...wow did it suck. it was just above a 2.0 and barely at that. way before i rear Scott's book i had done a little due diligence of my own. "how could i get my gpa up?"...and not only get it up, but enough to get the schools to want me, and do it quickly, easily, and CHEAP! after all i had funded all this on my own. well...at any local community college there are classes for the 'community'. and not everyone in this 'community' is an academically minded person. but the schools want to make money and gear courses to the masses. these courses still look and work like regular classes and i saw that and i ran with it.
check this quick ehow i wrote up
listed there are the courses i took: TENNIS, ART 1 & 2, and ARCHERY, yes archery. my gpa went from the bitter low it was to a 3.3 and it kept climbing. of course i had other courses to do mind you, but i did my work in those as well. i did an over all 180 and took the highway to a high gpa. that kinda rhymes.
as soon as i completed the required courses and my FUN courses i had a 3.6 gpa and i applied. dont you know i got accepted preliminarily right away while thousands, yes thousands were turned away as fast as i was accepted. the program i entered took 100 students total from an applicant pool of well over 3500. the school was renowned for its ability to take its student body and create an extremely high percentage of passing board certified RN's. its rank easily outdid that of the local and not so local 4 year programs and even ivy league facilities. so as you can see they were in high demand, and would of course only take the best applicants.
doing as i just told you, i slipped into that community of 'best'.
now of course while in the program i would go up and down. as is my nature. i was still not the best student as i am lazy by nature when it comes to studies. i still slept in class, i was still late by the maximum allowed days, and i lived by the creed 'C equals RN'.
i know my teachers saw that i was not a book smart student, but i also know that i shined on the hands on part. and that does count a lot with nursing. you can be a very book smart person, but if you cannot apply it you will be very limited in the office work available.
well, i skimmed by and along came finals. people passed and a very limited number of one failed, doomed to repeat the next year. no that wasn't me, but i was close. i didn't find out my final 'decision' rather than grade until 2 hours after the others did. apparently a meeting was held on my behalf, i was put on hold to wait for that decision. 2 hours is a long time when you're waiting for something like this. TWO HOURS. i am not a drinker, but a handful of classmates took me across the street and easily did i take down the majority of 2 pitchers.
i didn't get a grade so i don't know if i actually failed, or if i just barely passed, i dont know, although by the story one might discern one versus the other. what i do positively know is that i was told after 2 hours of waiting that i would need to return during the summer....to walk for graduation!
i should hope that i need not extend the feelings flowing through my body at that point in time. indescribable. yet imaginable.
i'd like to let it be known that i AM a good nurse, i AM a compassionate nurse (where it is due), and i am ever grateful to the faculty's time spent during those 2 hours on the topic of my passing. and not to boast, only so you know i didn't let you down, i was given the award of nurse of the year by all the residents in my department...a level 1 trauma center, one of the busiest in the united states. thank you
there's lots of disappointment in life and we get upset. we get upset over what went wrong or why something didn't go our way. the book highlights those reasons, and the main one goes to the effect that you...me or we, didn't do our due diligence. meaning that we didn't cover all of our bases before we went forward in expecting the positive and correct (for us) outcome.
i've been pretty successful in implementing this into my life. still some holes, but im working on it. and i do see a difference in my personal outlook on life, not only with the way i see things, but also the way they effect me. all in a positive way.
ok ok, a little rant but there's some reference to the main topic there. the story is that i wasn't a good student. i slept in class, right in front of the teacher. i was late, i didn't do all my work. i sucked at school. which is a strong reason i originally dropped out during my first semester in college. i went the, what i thought was, the easy way out and enrolled in something i liked....automotive school. my first day on the job i knew that i couldn't do this all of my life.
i met a very nice man...knocking on 50's, living at home with mom and dad, no girlfriend, wearing suspenders, talking to himself and driving what he called a 'chick magnet'. ok super run on sentence there but if you've read any of my entries from previous you know im about thought, not the process :p anyway, it was to get the point through without interruption....i just couldn't do it. i didn't want to end up like this. don't get me wrong, he was the nicest guy, he'd help you out and stick up for you. he lent me any tool that i needed especially the most important one, his mind. super smart guy, he was, a great technician and probably the best i've known in my 6 professional years of automotive.
anyway, i went right back to college when i saw this guy and boy was i motivated. motivation or not i didn't have the best starting grounds. my gpa...wow did it suck. it was just above a 2.0 and barely at that. way before i rear Scott's book i had done a little due diligence of my own. "how could i get my gpa up?"...and not only get it up, but enough to get the schools to want me, and do it quickly, easily, and CHEAP! after all i had funded all this on my own. well...at any local community college there are classes for the 'community'. and not everyone in this 'community' is an academically minded person. but the schools want to make money and gear courses to the masses. these courses still look and work like regular classes and i saw that and i ran with it.
check this quick ehow i wrote up
listed there are the courses i took: TENNIS, ART 1 & 2, and ARCHERY, yes archery. my gpa went from the bitter low it was to a 3.3 and it kept climbing. of course i had other courses to do mind you, but i did my work in those as well. i did an over all 180 and took the highway to a high gpa. that kinda rhymes.
as soon as i completed the required courses and my FUN courses i had a 3.6 gpa and i applied. dont you know i got accepted preliminarily right away while thousands, yes thousands were turned away as fast as i was accepted. the program i entered took 100 students total from an applicant pool of well over 3500. the school was renowned for its ability to take its student body and create an extremely high percentage of passing board certified RN's. its rank easily outdid that of the local and not so local 4 year programs and even ivy league facilities. so as you can see they were in high demand, and would of course only take the best applicants.
doing as i just told you, i slipped into that community of 'best'.
now of course while in the program i would go up and down. as is my nature. i was still not the best student as i am lazy by nature when it comes to studies. i still slept in class, i was still late by the maximum allowed days, and i lived by the creed 'C equals RN'.
i know my teachers saw that i was not a book smart student, but i also know that i shined on the hands on part. and that does count a lot with nursing. you can be a very book smart person, but if you cannot apply it you will be very limited in the office work available.
well, i skimmed by and along came finals. people passed and a very limited number of one failed, doomed to repeat the next year. no that wasn't me, but i was close. i didn't find out my final 'decision' rather than grade until 2 hours after the others did. apparently a meeting was held on my behalf, i was put on hold to wait for that decision. 2 hours is a long time when you're waiting for something like this. TWO HOURS. i am not a drinker, but a handful of classmates took me across the street and easily did i take down the majority of 2 pitchers.
i didn't get a grade so i don't know if i actually failed, or if i just barely passed, i dont know, although by the story one might discern one versus the other. what i do positively know is that i was told after 2 hours of waiting that i would need to return during the summer....to walk for graduation!
i should hope that i need not extend the feelings flowing through my body at that point in time. indescribable. yet imaginable.
i'd like to let it be known that i AM a good nurse, i AM a compassionate nurse (where it is due), and i am ever grateful to the faculty's time spent during those 2 hours on the topic of my passing. and not to boast, only so you know i didn't let you down, i was given the award of nurse of the year by all the residents in my department...a level 1 trauma center, one of the busiest in the united states. thank you
Thursday, April 16, 2009
so what is it that YOU do?
nursing is a pretty sweet field in that there are so many different possibilities and venues to work in. during school hours i was encouraged to do med/surg for a year and then branch off to where i wanted to go. in thinking about it i didn't see myself as a bedside nurse with the same patients for hours and maybe even days. i didn't exactly see myself in emergency nursing either but i did enjoy the chaos. that was my draw. everyone says that there are different fields...and of course there are! but what are the unconventional fields out there? my wife will be attending a legal nurse consultant conference in the near future. i hope to expand to a bsn and ultimately a nurse anesthetist program.
so...what is it that YOU do?
so...what is it that YOU do?
Tuesday, April 14, 2009
tourettes enlightenment
so i've just come back from a little vacation. my grandmother just turned 90 this past weekend, amazing. don't really think i'd make it to that, and the thought of doing so isn't so appealing. always imagined kicking it while still able to hold my bladder, but then again i have problems with that in the field of work im in.
anywho, so the flight into LAX was pretty much uneventful. it was a short time away, so the 6 hour flight gives much to be desired in the sleep category. i get there, have problems adjusting, and by the time i do adjust its time to get home. well the day after i arrive at home i start a couple days of long shifts, so i need to prepare. im all set to get a little shut eye on the long flight home. i walk the airport, scouring over what i can package in my bag. i stock on ice in my nalgene for a cold refreshment during the flight should i wake. and i pick up some other snacks as i would most assuredly miss the on flight beverages and not pay the obscene prices of their food. i even picked up a paper to peruse over as reading helps me sleep.
all set, GREAT! im good, im planned, im collected...just need to get to my seat and close my eyes. sweet right? not so much.
now im in the middle seat and to my left is a nice lady who is quite and seems conducive to sleeping on flights. to my right is a mid 40s man who to no fault of his own cannot keep still, keep quite, or fall asleep. for 6 everlasting hours do the surrounding passengers hear his intermittent moans and grunts.
during the movie, marley and me (a very sad movie by the way) he would laugh and make comments out loud...the type of comments you and i would definitely keep to ourselves.
prior to the video he had a newspaper in hand, continually pointing and grunting, then folding to a different section. at the pace with which he did this it was almost a positive that he wasn't even reading the paper. he'd eventually crumple the paper, stick it in his side which was also my side and hide it there to only select it again for use.
in between papers he did stop to have a light snack. a muffin, apple, and a juice. all of which ended up everywhere. the muffin fell to the floor which i attempted to help on the 1st and 2nd times. the apple made touch down before we did approximately 4 times, and the juice lay nicely on his shirt, lap, and a bit on my right arm.
countless times did he unbuckle, regardless of the seatbelt sign, to retrieve his lost items. even the stewardesses gave up on correcting this action due to the lighted signs.
bless his soul, the gentleman directly in front of this guy had his seat back pushed, shoved, kicked, kneed, pulled, and manipulated so that you could visually see his hair move from the swift actions by my next door neighbor. he truely took it like a champ, and i believe he had it worse than i did.
now the entire time i was in attempts to help when he dropped or needed something and skillfully ignored the constant vocal exclamations. no i wasn't mad, or disgusted. i felt sorry for the man. i felt sorry that he had no control over this. im sure that there were a number of things going through his head that even he probably had no idea of. as mentioned he was of maybe an average 40's, and wasn't dirty or unkempt. he looked clean, proper...he looked like the social norm. his actions are what set him apart from the rest. he obviously has mind enough to keep himself this way, and not into the deep caverns of the mind that many end into. realizing this, i not only felt sad, but also impressed.
what an accomplishment of his own to maintain composure over whatever was making him this way, and keeping himself in tuned with the world of today...mobile and social. it would be easy to believe others would have turned into the house trolls with overwhelming agoraphobia. very impressive.
so 6 hours of this experience, i was definitely tired. and i paid a little price, i was late getting up for work the past 2 days and rushing was my penance. i do believe that i have adjusted more to the daily time and living here on the east. and in reflection i feel thankful for the time i had with him. it brings to light a number of different things. i am grateful for that which i have...my health, my mental health, my family, my life, even my troubles. my troubles for that i know, increasingly so, that it could definitely be worse. i could have similar setbacks, and i may not be as strong as this man was. its a different spin on looking at things. when i first met my wife, then girlfriend, she would constantly say 'it could always be worse'. well that's been a bit of a stable in my daily life. i get killed at work, a horrible day but not the worst...it could be worse. during the winter i almost crashed twice in one commute to work...i didn't, and it could have been worse. a fight with my wife, it didn't escalate...it could be worse. my mother in law lives and works with just under 30% of one lung, im lucky to have 2.....
to take from this is the statement, "it could be worse". whatever it is that you are into, just think of what others are overcoming or attempting to. in the fast paced world we live in, take a moment, set aside a few seconds here and there...
realize that you are so very blessed to have what you have.
realize that not all have that,
and do not for a second take for granted that which you have been given...
given by your own hand, another's, or by no physical hand at all.
anywho, so the flight into LAX was pretty much uneventful. it was a short time away, so the 6 hour flight gives much to be desired in the sleep category. i get there, have problems adjusting, and by the time i do adjust its time to get home. well the day after i arrive at home i start a couple days of long shifts, so i need to prepare. im all set to get a little shut eye on the long flight home. i walk the airport, scouring over what i can package in my bag. i stock on ice in my nalgene for a cold refreshment during the flight should i wake. and i pick up some other snacks as i would most assuredly miss the on flight beverages and not pay the obscene prices of their food. i even picked up a paper to peruse over as reading helps me sleep.
all set, GREAT! im good, im planned, im collected...just need to get to my seat and close my eyes. sweet right? not so much.
now im in the middle seat and to my left is a nice lady who is quite and seems conducive to sleeping on flights. to my right is a mid 40s man who to no fault of his own cannot keep still, keep quite, or fall asleep. for 6 everlasting hours do the surrounding passengers hear his intermittent moans and grunts.
during the movie, marley and me (a very sad movie by the way) he would laugh and make comments out loud...the type of comments you and i would definitely keep to ourselves.
prior to the video he had a newspaper in hand, continually pointing and grunting, then folding to a different section. at the pace with which he did this it was almost a positive that he wasn't even reading the paper. he'd eventually crumple the paper, stick it in his side which was also my side and hide it there to only select it again for use.
in between papers he did stop to have a light snack. a muffin, apple, and a juice. all of which ended up everywhere. the muffin fell to the floor which i attempted to help on the 1st and 2nd times. the apple made touch down before we did approximately 4 times, and the juice lay nicely on his shirt, lap, and a bit on my right arm.
countless times did he unbuckle, regardless of the seatbelt sign, to retrieve his lost items. even the stewardesses gave up on correcting this action due to the lighted signs.
bless his soul, the gentleman directly in front of this guy had his seat back pushed, shoved, kicked, kneed, pulled, and manipulated so that you could visually see his hair move from the swift actions by my next door neighbor. he truely took it like a champ, and i believe he had it worse than i did.
now the entire time i was in attempts to help when he dropped or needed something and skillfully ignored the constant vocal exclamations. no i wasn't mad, or disgusted. i felt sorry for the man. i felt sorry that he had no control over this. im sure that there were a number of things going through his head that even he probably had no idea of. as mentioned he was of maybe an average 40's, and wasn't dirty or unkempt. he looked clean, proper...he looked like the social norm. his actions are what set him apart from the rest. he obviously has mind enough to keep himself this way, and not into the deep caverns of the mind that many end into. realizing this, i not only felt sad, but also impressed.
what an accomplishment of his own to maintain composure over whatever was making him this way, and keeping himself in tuned with the world of today...mobile and social. it would be easy to believe others would have turned into the house trolls with overwhelming agoraphobia. very impressive.
so 6 hours of this experience, i was definitely tired. and i paid a little price, i was late getting up for work the past 2 days and rushing was my penance. i do believe that i have adjusted more to the daily time and living here on the east. and in reflection i feel thankful for the time i had with him. it brings to light a number of different things. i am grateful for that which i have...my health, my mental health, my family, my life, even my troubles. my troubles for that i know, increasingly so, that it could definitely be worse. i could have similar setbacks, and i may not be as strong as this man was. its a different spin on looking at things. when i first met my wife, then girlfriend, she would constantly say 'it could always be worse'. well that's been a bit of a stable in my daily life. i get killed at work, a horrible day but not the worst...it could be worse. during the winter i almost crashed twice in one commute to work...i didn't, and it could have been worse. a fight with my wife, it didn't escalate...it could be worse. my mother in law lives and works with just under 30% of one lung, im lucky to have 2.....
to take from this is the statement, "it could be worse". whatever it is that you are into, just think of what others are overcoming or attempting to. in the fast paced world we live in, take a moment, set aside a few seconds here and there...
realize that not all have that,
and do not for a second take for granted that which you have been given...
given by your own hand, another's, or by no physical hand at all.
Monday, April 6, 2009
scrapper assault
ok so in these hard economic times there are differences in what people are willing to do for money. one such thing is scrap steel and other metals. prices for these are at all time highs, especially for copper. depending on what type of neighborhood you live in you may have a number of trucks rolling by with multiple people in them. they're looking for signs of any metals
and when spotted they jump out and end up scouring through your trash, usually making a mess of things. taking what they want so they can resell and make a profit, all the while leaving your trash scattered.
this, my friends, is actually illegal. the trash is city property and these people are stealing. there is a large profit to be made by this, and these people have figured it out and are using their trucks to hoard and steal and make money.
well, one of my recent patients, a super nice guy, has a little stock pile of scrap steel and wood in his back yard. he did work here and there for himself, and others. being retired he just kept the stuff around which he collected over his many years of construction and other handy work. over some time he had noticed that his stockpile had been slowly decreasing. he sat around watching his stash as he spotted a young man of decent taking his steel and running out to his truck and driving off.
John had a leisurely life so he sat around waiting and watching for that man to return, and sure enough he did. John decided to confront this young guy for stealing his stuff. John stepped out and said a few words walking toward the young man, who in turn grabbed a 2x4 of wood and proceeded to swing at John's head. the 2x4 did connect with John's head on multiple occasions making him stumble, yet John was good enough to get a few swings at this younger and stronger guy, also striking him a few times. the man eventually ran off leaving John to bleed profusely from his wounds.
about 20minutes later John makes it into my emergency room via PFD medics where he is trauma cleared and placed into my room for triage and care. there were over 10 staples needed to close the wounds inflicted by this thief. John was very proud that he wasn't knocked out and even fought back as best he could. during his triage, the police came by with a young ethnic man in tow. tugging and attempting to pull away while cuffed and looking down at the ground he was presented to John. "Yea, thats him" he said "did i get him?" he exclaimed unable to visualize any markings due to the blood dripping in his eyes. "John, you got him good, you did great" i said.
John, who was clearly into his late 60's was so overwhelmed with happiness that he got him back that his staples went in without a flinch. the police, detectives, and myself praised him for his heroic fight back. John felt accopmlished and on top of the world. he was eventually cleared and discharged, police officers gave him a ride to the district to make a report and file charges. it was a hassle, but John didn't care, he was still floating. He was old, but didn't give up, and didn't shut up. he was on clouds.
the jacka** kid had a superficial scratch on his neck.
as happy as i was of the outcome and of making John feel better, i couldn't help being bothered by the story he had to tell me. what is going on in this world...
and when spotted they jump out and end up scouring through your trash, usually making a mess of things. taking what they want so they can resell and make a profit, all the while leaving your trash scattered.
this, my friends, is actually illegal. the trash is city property and these people are stealing. there is a large profit to be made by this, and these people have figured it out and are using their trucks to hoard and steal and make money.
well, one of my recent patients, a super nice guy, has a little stock pile of scrap steel and wood in his back yard. he did work here and there for himself, and others. being retired he just kept the stuff around which he collected over his many years of construction and other handy work. over some time he had noticed that his stockpile had been slowly decreasing. he sat around watching his stash as he spotted a young man of decent taking his steel and running out to his truck and driving off.
John had a leisurely life so he sat around waiting and watching for that man to return, and sure enough he did. John decided to confront this young guy for stealing his stuff. John stepped out and said a few words walking toward the young man, who in turn grabbed a 2x4 of wood and proceeded to swing at John's head. the 2x4 did connect with John's head on multiple occasions making him stumble, yet John was good enough to get a few swings at this younger and stronger guy, also striking him a few times. the man eventually ran off leaving John to bleed profusely from his wounds.
about 20minutes later John makes it into my emergency room via PFD medics where he is trauma cleared and placed into my room for triage and care. there were over 10 staples needed to close the wounds inflicted by this thief. John was very proud that he wasn't knocked out and even fought back as best he could. during his triage, the police came by with a young ethnic man in tow. tugging and attempting to pull away while cuffed and looking down at the ground he was presented to John. "Yea, thats him" he said "did i get him?" he exclaimed unable to visualize any markings due to the blood dripping in his eyes. "John, you got him good, you did great" i said.
John, who was clearly into his late 60's was so overwhelmed with happiness that he got him back that his staples went in without a flinch. the police, detectives, and myself praised him for his heroic fight back. John felt accopmlished and on top of the world. he was eventually cleared and discharged, police officers gave him a ride to the district to make a report and file charges. it was a hassle, but John didn't care, he was still floating. He was old, but didn't give up, and didn't shut up. he was on clouds.
the jacka** kid had a superficial scratch on his neck.
as happy as i was of the outcome and of making John feel better, i couldn't help being bothered by the story he had to tell me. what is going on in this world...
Friday, April 3, 2009
Cradle to the Grave
Check the new advance nursing magazine write up on the Cradle to the Grave program. this program has been the brain child of the chief trauma surgeon, amy goldberg, at a local hospital and along side her staff and the hard work of a very motivated individual, Scott Charles.
Scott takes high school students through a very graphic and detailed walk through of another young child's life. the story goes from his very early beginnings, to when he was taken away by gun violence here on the streets of philadelphia. they go through lectures, a bit of story telling, and walk through the actual trauma bay of one of the busiest Level I facilities in the US. in the bay, a reenactment of this young child's fight for life and death is presented to the high school kids, all in hopes of leaving an imprint on what the street life has to offer.
philly continues to be in the top 10 cities for gun related deaths. the cradle to the grave program has been up and running for many years, more than the 3 that i've been at this hospital. and hundreds of students walking through that trauma bay...all but one child had kept clear of the trauma bay since.
i personally would like to thank those efforts put forth by all the team of the cradle to the grave program. this needs to be recognized further and implemented in facilities all over the world. please, pass the word.
Scott takes high school students through a very graphic and detailed walk through of another young child's life. the story goes from his very early beginnings, to when he was taken away by gun violence here on the streets of philadelphia. they go through lectures, a bit of story telling, and walk through the actual trauma bay of one of the busiest Level I facilities in the US. in the bay, a reenactment of this young child's fight for life and death is presented to the high school kids, all in hopes of leaving an imprint on what the street life has to offer.
philly continues to be in the top 10 cities for gun related deaths. the cradle to the grave program has been up and running for many years, more than the 3 that i've been at this hospital. and hundreds of students walking through that trauma bay...all but one child had kept clear of the trauma bay since.
i personally would like to thank those efforts put forth by all the team of the cradle to the grave program. this needs to be recognized further and implemented in facilities all over the world. please, pass the word.
Monday, March 30, 2009
end of a long day's work...
well, you force yourself to get up. you get ready and make your way into work. you survive barely all day for your 12 or 16 hour shift and hopefully get out on time. you're excited to get out, you jump in your ride and start the seemingly forever long commute home. you just want to get that hospital funk off of you and roll right into bed. sounds great right? well this girl had a different idea...
"what, dad?"
"what, dad?"
Sunday, March 29, 2009
first experience off orientation as a new Murse...
well, this was quite some time ago. my wife, who was my coworker and friend at that time, was with me on that day. it was my first day off orientation, but she and others were around to give me a hand of course.
well, it was said that this one nurse [jane] had the worst luck and darkest cloud over her. anything and everything bad that could walked, pushed, or dragged though that double door would hit her bays. lucky for her i had come around.
feeling anxious nervous and confident at the same time i had started my shift. first hours of the day yielded the normal urgent non urgent ambulatory bumps and bruises, maybe an asthma here and there. then in comes a young guy by pfd medics. pale as can be, if you ask my wife, i have no skills in determining skin colors...but as white as a sheet of paper this guy was. chief complaint was severe abd pain with nausea...no vomiting yet. well, chey, slyly pointed out his paleness to me and states 'he's gonna crump on you'.
chey has many years of experience and can call out the sickies of the bunch. i've learned well to trust her instincts. we quickly setup the patient, triage, get him on the monitor and obtain bilateral access w/ iv fluids. well shortly after that does this guy do exactly was chey said he would.
take this picture and change the puke color to bright bright bright red.
projectile vomiting of the brightest blood i had ever seen and this guy was going for the record. tons of it just kept coming out of his mouth and shot at length about 4-5 feet, well past his own feet on the stretcher almost hitting the curtain.
dont you know we were singing a tune calling out for dr [John] to hightail his butt in my room. but all in all, some work went into it. this guy had a taste for coccaine, about 700 bucks a DAY he would spend and had done some serious damage. his numbers...H/H 3 and 9. impressive, but as luck would have it my last gi bleed out did these numbers.
i do believe i am getting proficient with gi bleeders and the Lord does give me good practice.
well, it was said that this one nurse [jane] had the worst luck and darkest cloud over her. anything and everything bad that could walked, pushed, or dragged though that double door would hit her bays. lucky for her i had come around.
feeling anxious nervous and confident at the same time i had started my shift. first hours of the day yielded the normal urgent non urgent ambulatory bumps and bruises, maybe an asthma here and there. then in comes a young guy by pfd medics. pale as can be, if you ask my wife, i have no skills in determining skin colors...but as white as a sheet of paper this guy was. chief complaint was severe abd pain with nausea...no vomiting yet. well, chey, slyly pointed out his paleness to me and states 'he's gonna crump on you'.
chey has many years of experience and can call out the sickies of the bunch. i've learned well to trust her instincts. we quickly setup the patient, triage, get him on the monitor and obtain bilateral access w/ iv fluids. well shortly after that does this guy do exactly was chey said he would.
take this picture and change the puke color to bright bright bright red.
projectile vomiting of the brightest blood i had ever seen and this guy was going for the record. tons of it just kept coming out of his mouth and shot at length about 4-5 feet, well past his own feet on the stretcher almost hitting the curtain.
dont you know we were singing a tune calling out for dr [John] to hightail his butt in my room. but all in all, some work went into it. this guy had a taste for coccaine, about 700 bucks a DAY he would spend and had done some serious damage. his numbers...H/H 3 and 9. impressive, but as luck would have it my last gi bleed out did these numbers.
i do believe i am getting proficient with gi bleeders and the Lord does give me good practice.
Friday, March 27, 2009
you can laugh but...
i think chest pt does work. im a huge proponent of it. many people tell me they haven't used it since their peds rotation in nursing school. well, i do use it in my practice where i may see it fit. and to my credit i did use it on a patient who came in with ?od, aspiration, and resultant respiratory arrest. severe to the point where she was consistently mid 60s on her pleth while intubated and the docs feared that ards was setting in and would take her. 
most everyone rolled out to do their other things and document. i sat around to help, eventually did some chest pt on her and slowly did her numbers climb. couple days later she extubated herself, went AMA and came back a couple weeks later as the same...she liked the nose candy and the street vitamin H. like i say, everyone needs a hobby.
most everyone rolled out to do their other things and document. i sat around to help, eventually did some chest pt on her and slowly did her numbers climb. couple days later she extubated herself, went AMA and came back a couple weeks later as the same...she liked the nose candy and the street vitamin H. like i say, everyone needs a hobby.
you're here to work
ok ed nurses listen up...how often do you end up holding patients in tracking to go upstairs because no one picks up the phone or makes excuses to take the patient?
way too often for me. certain floors continually give us grief over admissions. the patients are sick or complain that they are sick and someone believes them, or must prove them wrong. either way they get admitted and this is why we are lucky enough to have jobs. i understand that getting a new patient means getting off your butt. i like to sit on my butt too. but im also a worker, and when a patient comes through our door, me and most of my crew will get up and get to work if we are not already. this is how it goes.
i see that repeat offenders will tell me that a bed is not clean, when housekeeping makes it a point to tell us its clean, and our bed tracking system says its clean. sometimes i think the floor's staff sits in the bed just to say its dirty. one day last week a specific floor continually gave us problems sending patients. bed tracking AND housekeeping supervisors both tell us that beds are clean and ready. and the floor has new excuses with every patient and every phone call. 'we changed the room number', 'that room is our only isolation room', 'that nurse is off the floor', 'we didn't know about the pt', 'the room isn't setup for that type of pt', 'we don't have the ancillary staff', 'we dont, we dont we dont'.
its ridiculous really. now although the er could go on divert, i can't remember the last time we did. and even when we are wall to wall patients, new ones keep rolling in and we just sit patients in a chair or stretcher and make up a name for that 'pt care area'. this is what we do. no nurse to pt ratio cap, no locked doors on the medic/ambulance bays. and the walkers and drop offs still keep rolling in. and in fact its my opinion that most of the legitimately sick patients actually do not call 911 and hitch rides from family friends or buses.
we are all hospital employees, we are hired to do a job, there are tons of sick patients to take care of, you are expected to work. this is the reality of our work, you were aware of that when you started, you should know that when you come in to work today. so...pick up the phone, and no excuses.
way too often for me. certain floors continually give us grief over admissions. the patients are sick or complain that they are sick and someone believes them, or must prove them wrong. either way they get admitted and this is why we are lucky enough to have jobs. i understand that getting a new patient means getting off your butt. i like to sit on my butt too. but im also a worker, and when a patient comes through our door, me and most of my crew will get up and get to work if we are not already. this is how it goes.
i see that repeat offenders will tell me that a bed is not clean, when housekeeping makes it a point to tell us its clean, and our bed tracking system says its clean. sometimes i think the floor's staff sits in the bed just to say its dirty. one day last week a specific floor continually gave us problems sending patients. bed tracking AND housekeeping supervisors both tell us that beds are clean and ready. and the floor has new excuses with every patient and every phone call. 'we changed the room number', 'that room is our only isolation room', 'that nurse is off the floor', 'we didn't know about the pt', 'the room isn't setup for that type of pt', 'we don't have the ancillary staff', 'we dont, we dont we dont'.
its ridiculous really. now although the er could go on divert, i can't remember the last time we did. and even when we are wall to wall patients, new ones keep rolling in and we just sit patients in a chair or stretcher and make up a name for that 'pt care area'. this is what we do. no nurse to pt ratio cap, no locked doors on the medic/ambulance bays. and the walkers and drop offs still keep rolling in. and in fact its my opinion that most of the legitimately sick patients actually do not call 911 and hitch rides from family friends or buses.
we are all hospital employees, we are hired to do a job, there are tons of sick patients to take care of, you are expected to work. this is the reality of our work, you were aware of that when you started, you should know that when you come in to work today. so...pick up the phone, and no excuses.
your crew makes or breaks your day
you get up, you get ready and make your way into work. you clock in and check your assignment. not only that you look as to who your neighbors are. well, crap... if you don't have good fun people that are workers surrounding you, your day can absolutely just suck butt sideways.
for me at least it can really set my mood and overcast my day. just the other day i had across from me a nurse who doesn't really help anyone much less her own patients. and next to me i had a nurse who cant hold an assignment unless its a super easy day. my supportive staff were my only saving grace as they were strong. helping me and others so that i [selfishly] didn't have to go and help the others. a few traumas and codes are where i did help, but on the most part i was saved from the harsh reality of what was the job. it really did poop on my day and i was not happy.
makes me think of a week or so ago, when i had excellent A Team staff to work with. and holy butt kicking did we get. but with Docs that are nice, funny, and are into patient through-put...and RNs PCAs and LPNs that just work together and get things done, while having some laughs and fun in the middle...well to me that just creates the epitome of what a job should be.
if you can't have fun at your job, its a job. no one, but no one wants just a job. when you are surrounded by people that you care for and they care for you, you just have a great day no matter what happens. and let me tell you, that day we had the philly fire department at the front of our station all day, hastes and rapid responses all day, and not one of us got a break, much less time to micturate. but this is what we do, and our bladders and stomachs may suffer for it, but its our job, our passion, and our lives....and for days like that, we love it.
for me at least it can really set my mood and overcast my day. just the other day i had across from me a nurse who doesn't really help anyone much less her own patients. and next to me i had a nurse who cant hold an assignment unless its a super easy day. my supportive staff were my only saving grace as they were strong. helping me and others so that i [selfishly] didn't have to go and help the others. a few traumas and codes are where i did help, but on the most part i was saved from the harsh reality of what was the job. it really did poop on my day and i was not happy.
makes me think of a week or so ago, when i had excellent A Team staff to work with. and holy butt kicking did we get. but with Docs that are nice, funny, and are into patient through-put...and RNs PCAs and LPNs that just work together and get things done, while having some laughs and fun in the middle...well to me that just creates the epitome of what a job should be.
if you can't have fun at your job, its a job. no one, but no one wants just a job. when you are surrounded by people that you care for and they care for you, you just have a great day no matter what happens. and let me tell you, that day we had the philly fire department at the front of our station all day, hastes and rapid responses all day, and not one of us got a break, much less time to micturate. but this is what we do, and our bladders and stomachs may suffer for it, but its our job, our passion, and our lives....and for days like that, we love it.
Wednesday, March 25, 2009
i hate racism
and i hate racists
you'd think that in a time like this people would grow up and stop being small minded and self centered. the world in integrated, we are all brothers and sisters. why in this 21st century are we still fighting this battle? there are better things to argue over...AIG for one!
you'd think that in a time like this people would grow up and stop being small minded and self centered. the world in integrated, we are all brothers and sisters. why in this 21st century are we still fighting this battle? there are better things to argue over...AIG for one!
side by side, husband and wife
both my wife and i are nurses. i met her at my first hospital and BAM! 3 year later we were together :pwe left that hospital together and joined forces again at our current position. people ask me if its weird or difficult. honestly, i love it. she may have different opinions on that one. but i do love working with her. she is immensely smarter that i, and i can rely on her answers for quick resolutions to my confusion.
now when we have our issues to work out, it seems that at work, its work. we go in together maybe not talking, but we end up going home together conversing. at this hospital we don't have time to argue or think about arguing. we're told that it is the #2 (or 3 i dunno) facility in the U.S. for penetrating trauma. lots of fun.
now at the first er, where we met, the honeymoon phase was going on. but as that kind faded, unfortunately, we did have spats. but i do blame that on my immature mind set at the time. as you get older you realize what stupid things you've done in the past. and i've done many. we argued over stupid things like saying bye on the phone or text message. rediculous, now that im the mature and supremely fine specimen i am today.
things are definitely different now. but as good as things are now, i do see in the future that we won't be together in the workplace. we're venturing into different fields. forensics and teaching for her, and i want to fly and intubate people. juggling family, work, and each other we add school to further education and our careers. she's done a lot, im kicking my feet around a bit, but im starting to walk in a direction of worth.
i'll definitely miss working with her. her witt...she would call bs bs. find fault in the doctor's orders. questioned their thinking. she's the go to person for iv's. never nervous, always collected. she'd argue with attendings and get them to see that she's right pretty much every time. someone i would love to eminate but not be able to replicate.
counting days...
Tuesday, March 24, 2009
my first experience with life...as an rn
i graduated and passed my boards. prior to that i was recruited to the ed as a tech. i left house orderly position to focus on the er's needs. far more exciting and easily kept me awake at the hours i was working. so when i got my license they were ready with a contract for me. now Jane, from my first experience with death, became my preceptor in my new professional career. and how knowledgeable she was. she taught me alotwell, after i got used to the mumbo jumbo bumps and scrapes. i had finally gotten my first acute patient. female, 30s SOB all day, using nebulizers and mdi albuterol at home without any relief. now cyanotic, diaphoretic, lethargic, hypertensive, tachycardic, tachypneic, spo2 high 70's and looked to be knocking on that door. well, panic mode set it for a brief moment, then kick a** mode took place and stayed.
ok, ok. it was just an asthma attack. but damn did that girl look like she was gonna die to me, and she very well may have without intervention. and that's what i realized. on the broad spectrum of things, it was my intervention that helped turn that woman's condition around and ultimately in no apparent distress, walk out of the er....against medical advice!
the neighborhood we served was not the cleanest, and drug addicts and seekers were many. Jauncey was obviously no different. even though she did a 180, because of the severity of her original condition, she was to be admitted for observation and maintenance. but she had to get to the methadone clinic before it closed, so....
my first experience with death
flashback to 2002, i was a house orderly at a local hospital. i had to service all needs for the hospital from 7pm to 330am. so many times did i get paged to the er. and always a quick response. i loved it down there. always something to do, i was new and eager to learn and help. as the orderly i was responsible for delivering off hours food, transport, ekg's, running various items where needed, medical records, and cpr in the event of a code.
my first code was pretty much in my first week still in orientation with a preceptor. my shift was just about over, i was paged and ran down to the er. i saw what was going on, announced my presence and stepped up. i remember cracking a few ribs on this person's hard barrel-shaped chest. three or four times we got a rhythm with a pulse, and ultimately did that patient pass. i was devastated. this wasn't supposed to happen. i respond, i step up, i compress, i help, i save. that's what was advertised to me, "help save lives".
i'd never seen a dead body, much less touched one. the others stopped what they were doing, cleaned up a few things and left myself and the primary nurse in the room. i stepped out and sat on the floor against the wall. Jane came up to me and saw my face and read my mind. her words in verbatim were "when something like this happens, we act quickly and do what we can. but ultimately if it is their time, it is their time. just know that we did everything possible to prevent this from happening. when you get home, you should think about whether this is something you want to and can do. and if it is, we'd be glad to have your help."
the next day i was early for my shift.
my first code was pretty much in my first week still in orientation with a preceptor. my shift was just about over, i was paged and ran down to the er. i saw what was going on, announced my presence and stepped up. i remember cracking a few ribs on this person's hard barrel-shaped chest. three or four times we got a rhythm with a pulse, and ultimately did that patient pass. i was devastated. this wasn't supposed to happen. i respond, i step up, i compress, i help, i save. that's what was advertised to me, "help save lives".
i'd never seen a dead body, much less touched one. the others stopped what they were doing, cleaned up a few things and left myself and the primary nurse in the room. i stepped out and sat on the floor against the wall. Jane came up to me and saw my face and read my mind. her words in verbatim were "when something like this happens, we act quickly and do what we can. but ultimately if it is their time, it is their time. just know that we did everything possible to prevent this from happening. when you get home, you should think about whether this is something you want to and can do. and if it is, we'd be glad to have your help."
the next day i was early for my shift.
you have what it takes
its noted that it does take a special person to do what we do in the medical/nursing field. patients and their family members on many occasions tell me that they could never do what i do. it really is something special for myself to be able to take a person fighting the battle of their life, and turn them around; sometimes watching them get discharged and walk out of the ED.
its a little embarrassing to say that the reason i became a nurse was to make loads of money and work only 3 days a week at that. i would hang out with a friend and his dad would always be home to hang with us and take us places. i had come to find out that he was a nurse. he in fact did have a lot of nice things, a beautiful house, nice cars, and time to enjoy them.
that was it i knew what i was going to do. yea, there's the stigma of a nurse being a woman, but that didn't stop me. in fact, since being in the field i've seen that male nurses are highly regarded. my wife, also a nurse, makes it a point to state that because i have a penis, i have it easier. in short, i do believe she's right.
you women can be very petty. what is it about a woman proving herself against other women? now not all women, but when i came to the hospital i currently am at, i saw so much hostility amongst the females and the (attempt for political correct-ness) homosexual males. now not all were like this, but damn sure were there a good handful. and to be perfectly honest this did create a reputation for the facility i am now in. i have my reasons for pursuing it irregardless of this, i wanted to get my butt whooped and test my limits.
i do believe that this sole factor makes it super hard on anyone trying to make it in this field. you have new nurses, students, and old nurses new to the facility that find them having to prove themselves to a few snooty nurses that have far less experience than themselves. you also have residents that are themselves learning as we do everyday.
the other day a coworker whom i actually like, nicknamed a resident '[Jane] the Retard' and proceeded to laugh about it. of course none of us thought it was funny, and i voiced that opinion. well, its that attitude that creates such a hard learning environment. yes they are doctors, md's and do's...but they are still learning. they graduate, pass and get credentialed, then come to learn and play.
who are you, oh almighty nurse with er, icu, research, etc experience of so many years to call another a retard? were you so bright and perfect in intellect and hands on skill upon your first years of nursing? fresh from your boards were you able to assist clipping a dieulafoy's lesion on an active bleeder? did you differentiate the need for indepth liver function testing and ammonia studies for an unresponsive hypoglycemia pt with unknown incidental renal/liver pathology within you first months in the field?
i am honored and ashamed to work among these attitudes at the same time. yes, a number of the attitudes are seasoned and very appropriate with their skill. but so many times do i see the inappropriate side in regards to professionalism.
now also realize that i am not the silver dollar among the nickles. i am no super professional. i love the friendly environment that overcomes the hostility in my workplace. i have great rapport with most all, even the attitudes. and again, beccause of my penis it is easier for me than the likes of my wife. but we laugh, we joke, we are hilariously innapropriate at times, but when it gets down to it and the time demands it, we are a kick a** team, in a suck a** world.
its a little embarrassing to say that the reason i became a nurse was to make loads of money and work only 3 days a week at that. i would hang out with a friend and his dad would always be home to hang with us and take us places. i had come to find out that he was a nurse. he in fact did have a lot of nice things, a beautiful house, nice cars, and time to enjoy them.
that was it i knew what i was going to do. yea, there's the stigma of a nurse being a woman, but that didn't stop me. in fact, since being in the field i've seen that male nurses are highly regarded. my wife, also a nurse, makes it a point to state that because i have a penis, i have it easier. in short, i do believe she's right.
you women can be very petty. what is it about a woman proving herself against other women? now not all women, but when i came to the hospital i currently am at, i saw so much hostility amongst the females and the (attempt for political correct-ness) homosexual males. now not all were like this, but damn sure were there a good handful. and to be perfectly honest this did create a reputation for the facility i am now in. i have my reasons for pursuing it irregardless of this, i wanted to get my butt whooped and test my limits.
i do believe that this sole factor makes it super hard on anyone trying to make it in this field. you have new nurses, students, and old nurses new to the facility that find them having to prove themselves to a few snooty nurses that have far less experience than themselves. you also have residents that are themselves learning as we do everyday.
the other day a coworker whom i actually like, nicknamed a resident '[Jane] the Retard' and proceeded to laugh about it. of course none of us thought it was funny, and i voiced that opinion. well, its that attitude that creates such a hard learning environment. yes they are doctors, md's and do's...but they are still learning. they graduate, pass and get credentialed, then come to learn and play.
who are you, oh almighty nurse with er, icu, research, etc experience of so many years to call another a retard? were you so bright and perfect in intellect and hands on skill upon your first years of nursing? fresh from your boards were you able to assist clipping a dieulafoy's lesion on an active bleeder? did you differentiate the need for indepth liver function testing and ammonia studies for an unresponsive hypoglycemia pt with unknown incidental renal/liver pathology within you first months in the field?
i am honored and ashamed to work among these attitudes at the same time. yes, a number of the attitudes are seasoned and very appropriate with their skill. but so many times do i see the inappropriate side in regards to professionalism.
now also realize that i am not the silver dollar among the nickles. i am no super professional. i love the friendly environment that overcomes the hostility in my workplace. i have great rapport with most all, even the attitudes. and again, beccause of my penis it is easier for me than the likes of my wife. but we laugh, we joke, we are hilariously innapropriate at times, but when it gets down to it and the time demands it, we are a kick a** team, in a suck a** world.
shower time
couple weeks ago i went to help a trauma patient in distress. i didn't know what to expect, i just went over. before i realized she had her hand over her mouth i was head to toe in vomit....soaked. first time using the shower in the locker room. it has cold water but i didn't care.
do you ever get used to the gi bleed smell
i think i just might be. i have a strong stomach and head. but initially i would wince....now after a few years of this im starting to realize it doesn't phase me as much....interesting
nice for a change
so, not always is there a bad experience. the other day i actually had not one nasty patient. everyone of mine was polite, quiet, and nice...regardless of their condition. of course one was intubated, but again, as she awoke while intubated she was cooperative, calm, and collected. much more than i can say about some... this is truly a blessing
Monday, March 23, 2009
its a simple concept
there is a waiting room, where you wait. then you get in the treatment area, where you wait to be treated. this happens in the er, it happens in a clinic, it happens in your doctors office. its not that hard to get. and no, we dont have 50 doctors in the er, waiting for you to come through the door, and all attack your problems at once, especially when you're here for back pain from a car accident in '98 that you've run out of percocet for.
my arm hurts
so i'm working in the er, patient is moaning and groaning in front of myself and the physician... "my arm is killing me, and i can't move it at all" i go to assist him in removing his shirt, "sit up" i said. as i pull up his shirt he lifts both arms in a fluid like motion to assist me removing his shirt. he got a nice stare from myself and the md, and a prompt discharge
um...
so, i graduated in '04 and passed the rn boards that same year. well, i am now precepting students as most staff nurses do and i can see where i once was. the young nurse out to save everyone and help in any which way i can. wait, i still do that...to a degree. but i've become that which that i knew i never would be....jaded. and you know what did it? the drug seekers, they jobless that refuse to get a job, the healthcare abusers, the meal seekers, and the patients that just want to waste your time, get discharged and them go directly to triage to do it again! i only wish i had such time. it must be fun for them. frustrating for me!
im on shift yesterday and i had a student. very nice, very bright young girl about to graduate. and im trying to sit on my butt and work on my decubitus ulcer. and every second she's asking me to help with this that and the other. don't get me wrong, im a worker, i am a runner. but sometimes....you just want to have a sore butt, you know? and im not knocking the student either, she helped me immensly that day as did my coworkers with my critical patients.
also, since this is my first blog, you'll hear stories from present past and the unforseen future, in no particular order. if you don't like, please feel free to pretend you do like.
im on shift yesterday and i had a student. very nice, very bright young girl about to graduate. and im trying to sit on my butt and work on my decubitus ulcer. and every second she's asking me to help with this that and the other. don't get me wrong, im a worker, i am a runner. but sometimes....you just want to have a sore butt, you know? and im not knocking the student either, she helped me immensly that day as did my coworkers with my critical patients.
also, since this is my first blog, you'll hear stories from present past and the unforseen future, in no particular order. if you don't like, please feel free to pretend you do like.
first of many...
well, you must know that i am a nurse. i work and have worked for a number of hospitals and facilities, and have interacted with many people...and this will be my venting point. i do 12-16 hour shifts in an horrible world where people shoot each other, shoot themselves, and poop on themselves. you, my friends, will hear the stories of work and life, good and bad. and if you can/will, share your own.... so you know, all names will be changed to either John, Jane, Jimmie, or Jauncey :P
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