Tag: nursing

Since I’m stuck at work today for 16 hours–and I feel the need to tell you that I only agreed to do this because I was awarded tomorrow off, and they will be paying me for four hours that I won’t have to work, and I also have Thursday off, as well as this weekend, so it’ll be almost like a mini-vacation–I figured I’d quickly tell you about how I came to fulfill #35 on my 101 goals list: Thoroughly research nurse practitioner programs in the area and decide whether or not to enroll.

Ever since my mentor told me I should become a nurse practitioner, I’ve been thinking long and hard about it. I love my job, but I probably won’t want to do bedside nursing forever. I have it in me to advance in my career, and I realized that I won’t be satisfied with myself if I don’t try. After being a charge nurse for the past few months, I know that I don’t want to go into management. Being a nurse educator has never appealed to me either, although it’s definitely better than the former. But what I love about nursing is the patient care. The best way to advance in patient care is to become a nurse practitioner.

A lot of people have asked me what the difference between a nurse practitioner (NP) and a physician’s assistant (PA) is. They both perform similar roles in that they require the supervision of a physician but can see patients on their own, write orders, prescribe most common drugs, and diagnose and treat common illnessess. NP’s can actually have a somewhat independent practice while PA’s cannot, but the difference is mainly in how they are trained. NP’s are registered nurses, and we are taught to focus more on the biopsychosocial issues with an emphasis on wellness, disease prevention, and adaptation. PA’s are usually affiliated with medical schools and focus on the biological/pathological aspects of health, diagnosis, and treatment. Bored yet? Still interested? Here is a chart comparison of the two.

Although I get really excited about the prospect of becoming an NP (did I mention they make like three times as much as an RN?), I have some concerns. Mainly money for education and free time. There is no way I’m taking out more student loans, and I don’t want to stop working. That means I’ll have to work and go to school at the same time. I found out that my hospital will reimburse me for tuition up to $2500 a year which is totally enough for 3-4 classes/year at my alma mater. UT is one of the best schools in the area and also very reasonably priced. Even though I knew I didn’t want to be anything other than a longhorn, I looked into other schools just in case, but they were more expensive. Score!

So as of now, here’s my plan. Next year, I’ll become oncology certified. Then I’ll start thinking about taking the GRE. I’ll look to apply for NP school either next fall or the following summer. And THAT is scary…but exciting!

This past weekend, I worked. 24 hours. I slept about 14. I commuted 4. The time I had to do what I wanted was maybe 2 hours total. Then on Monday, I worked another 8 hours. When I came home, I took a 3-hour nap, and I never nap. Then I woke up, ate, read a little, and went back to sleep. My husband misses me.

But today is a new day! I am SO well-rested, and despite the fact that I truly did injure my ankle doing NOTHING (maybe I stepped wrong?), I have so far been able to clean the whole house, do some laundry, and watch last night’s episode of DWTS. Next up is the dog park with a friend, and dinner with my in-laws’ tonight.

I’m never scheduling myself that kind of weekend again.

By now you should probably know that I’m a nurse, right? I mean it says so right there in my header. And you may or may not know that I’m an oncology nurse, which means I take care of cancer patients. There are some types of chemotherapy that can only be given in the hospital, and that’s a big part of what we do. We also have a lot of people come in because of dangerously low blood counts, or complications thereof (i.e. infection) because that is a major side effect of chemotherapy. I give a lot of transfusions.

Almost everyone hates Mondays, and I’m no different. I really hate Mondays at work. Since a lot of our patients are just coming in to get chemo, they come in during the week and then they’re out by the weekend. That means when Monday rolls around, we get slammed with admissions and orders. And the bad thing is that our staffing is determined by the number of patients that we actually have on the floor during the previous shift, not by how many patients we’re expecting.

All that to say that Mondays are crazy.

Every day when I first get to work, I write out a report sheet on the patients I’m assigned to that day. We lovingly refer to this as our “brain”. This is mine from today, right after I wrote it at around 6:45 a.m.:

Names intentionally removed. Anyone heard of HIPAA?

And this is the same piece of paper at the end of the day:

One patient is crossed out and another one added because about an hour into the shift a patient decided that he didn’t like the nurse he had, so I traded with her. And of course right when I was getting things under control I got an admission. I had run out of room on my paper so I added another column myself on the back:

Some things I did today:

• Platelet transfusion
• Blood transfusion
• Assist with bone marrow aspiration and biopsy (a procedure that still gives me the shivers because of the way you can hear the giant needle grinding into the bone)
• Draw blood
• Admit a patient
• Normal assessments and medications, oral and IV
• Waitress (or at least I felt like it)

In the scheme of things, this Monday wasn’t all that bad. One of my mentor’s expressions is, “I can deal with anything for 8 hours.” I knew I only had an 8-hour shift to work today, and then I’d be home free with a day off tomorrow.

Of course, then I go back for 12 hours on Wednesday. I wonder if the saying still applies?

This week starts a new phase in my work life, one where I have three whole days off a week. Hence the reason why I am lounging around in my bed at this moment even though I had the weekend off. (I am also lounging around in my bed because I’m still not feeling great. The congestion just WON’T GO AWAY.) Yesterday I worked my first 12-hour shift. Well, not my first 12-hour shift EVER. I did them when I was in school, and I’ve done them for overtime. This was just my first 12-hour shift in my new schedule.

I think I am going to love it. First of all, once I’m already there it’s so much easier just to stay. I loved being able to finish up tasks that I normally wouldn’t have been able to do, and pass my patients off to the next nurse with a clean slate. It was also amazing how once 3 p.m. came and went, the unit got so much quieter. I am convinced that day shift is the craziest, no matter what anyone says. We have the most admissions and discharges, the most doctor’s orders to carry out, and the most tests to send patients to. But that’s beside the point. The point is that I’m already wishing I did three 12-hour shifts a week instead of two 12’s and two 8’s. This extra day off is bliss.

Moving on to my next subject: student nurses. I was one not very long ago. And when I was one, I vowed that when I became a nurse I would be extra nice to the students and try to help them whenever possible. However, I anticipated that I wouldn’t be working with students for years. But here I am, 15 months into being a nurse, and I have already worked with (counting them up now) FIVE student nurses. Methodist is a teaching hospital so we get them all the time. And I understand not wanting to overburden the more seasoned nurses on our unit with students all the time, because we have a lot of young nurses on our floor. I also know that it is a huge compliment that they continually ask me to precept these students.

But really, I don’t think I’m qualified. Most of the time I can get through the day with a student without them realizing that. I try to be as nice and helpful as possible, but last week I had a student that just about did me in. It took 20 minutes just to write down the morning lab results. I’ve never been asked so many questions before in my life. And whenever I didn’t have a complete answer for her she looked at me as if I was stupid. Not to mention the amount of times my career flashed before my eyes thinking she was going to report me for not doing things exactly the way they teach you in school. (Confession: I don’t check my patient’s armband every single time I give medication. Also, sometimes I leave it at the bedside for them to take when they’re ready. Does this make me a bad person? I hope not.)

So the student was extremely needy and judgmental, but don’t get the idea that she was a know-it-all. On the contrary, occasionally I wondered how she made it to her second semester. I can’t tell you how many times I had to explain to her how to calculate infusion rates.

Me: So if I have a 50 cc bag, and I want it to go in over half an hour, how many cc’s per hour does it need to go?

Her: blank stare.

Me: OK. If I have a 50 cc bag, and I want it to go in over ONE HOUR, how many cc’s per hour is that?

Her: …50?

Me: YES. So if I want it to go in over HALF that time I just need to DOUBLE the infusion rate. Does that make sense?

Her: Yes…

Me: So what would it be?

Her: blank stare.

I thought I was going to snap at one point. Anyway, despite all of this, it seems that the student actually LIKED me. So lucky me, I will get to be with her again 1-2 times a week this entire semester. Yay!

Finally, let’s address my ever-expanding wish list. I’ve already shared my biking wants, now it’s time for my nursing-related wants.

1. Cherokee Workwear scrubs. After informal surveys, extensive online research, and acute observation I have decided that this is the brand of scrubs that fit the best. I would like at least three pairs of Caribbean blue and two pairs of other colors.

2. New socks to wear to work because mine are all wearing out. I want some that are ankle high and are either black or have cute stripes or designs.

3. Multi-colored pens. Black and red are essential, blue and green are helpful. It’s so much nicer to have all the colors in one pen.

4. A little pocket organizer. No matter how dorky it looks, I’d like to try it out. I think it’d be good to have a place to store my scissors, pen light, and other random supplies without them getting all jumbled up.

I don’t know if any of this was interesting to anyone who isn’t a nurse themselves or in my family, but there you have it anyway. Hope you are all enjoying your week, and now I’m going to go attempt to salvage this day off.