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? :)

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.

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.

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.