Friday, May 30, 2008

I got a new job

I have worked in CCU for 7 1/2 years now.  I have finally decided it is time for a change.  From time to time over those 7 1/2 years gotten restless and looked at the job postings and even considered and applied to go to labor & delivery but didn't get the job.  But this time it was for real.  

Part of what made me know I was ready for something new was my comfort level in CCU.  When I first started there I used to drive into work wondering who I was working with.  Hoping that certain people would be on with me knowing that if they weren't there it could be bad......real bad.  This was because I couldn't handle just anything that came through those doors.  I could handle the basics.  My patient would tell me he was having chest pain......ok, check to make sure his o2 is in, do an ekg, give him some morphine, turn his nitroglycerine up, etc....I had my check list to run through.  Situation handled.  Someone's BP was in the 70's.......either turn the drip causing it down/off or give a bolus of IVF or start a pressor, etc.  Situation handled.  Someone went into flash pulmonary edema........oh crap this was a REAL crisis!!   Or someone went into severe resp distress, or was in cardiogenic shock, etc.  Those were things I was unprepared to handle.

But give me 7 1/2 years under my belt and for the last several I could care less who I was working with except for the friendships that were there for the shift.  I could also care less what came through the doors, in fact the sicker the better in my opinion.  I always volunteer to take care of the sickest patients in the unit.  The best shifts are ones that involve some sort of crisis situation.  Don't get me wrong, I do feel bad for the person involved and I do my absolute best to give them the best but I live for the intensity of it.  I've moved from being a scared green CCU nurse to being in charge about 50% of the time that I work.  People actually look up to ME!!  Never thought when I came to CCU that would happen!!  It's a good feeling though.

About 18 months ago our hospital started a MET.  It stands for medical emergency team.  It is a team made up of an ICU or CCU nurse and a respiratory therapist that respond to the inpatient floors when a nurse from there calls for an acute change in their patient's condition.  It's purpose is to prevent inpatient deaths.  I really like being a part of this team and teaching novice nurses to critically think etc.

But all along we have complained to management that the problem with the team is that it takes us away from our own critically ill patients.  When a MET call goes out I have to leave my 1-3 critical patients anywhere from 20-60 mins to evaluate this other patient and give my recommendations on how to handle the situation.  Sometimes these patients are able to have some treatment and stay there and sometimes they are moved to the ICU or CCU.  The entire time the team has been in existence we have asked for a nurse to be dedicated to this position.

Finally...............they listened!!!  And created a position called a resource nurse.  It is only on the off shift so I will stay the same hours 7pm-7am and still 3 days a week.  But since there isn't a MET called every night there will be other responsibilities too.  I will also respond to all code 8's in the hospital (our call for an inpatient death) and all BAT's which is our brain attack team or acute stroke to evaluate whether a patient having an acute stroke can receive the clot buster drug to lessen the severity of the stroke.  Then in my downtime I will be rounding on the inpatient units and helping to "put out fires" and trying basically to prevent bad outcomes for patients.  Nurses can call me if they are unsure of a situation or procedure etc.  

I'm sure there will be some grunt work involved and some aspects I won't like but all in all I'm excited and looking forward to it!!  It's a great change.  I love bedside nursing but at the same time there is a lot of bedside nursing that I'm sick of and won't miss.  Doing this I'll still be doing bedside nursing but not to the degree that I do it now.  I'll be starting in mid-July.  

Friday, May 23, 2008

Why I became a nurse

I didn't always want to be a nurse. In fact, when I was younger I had wanted to be a veterinarian. From the time I was a kid until I worked for my first vet I knew that's what I'd be. But then it just wasn't for me. (That's another story though!!) While I was in college trying to figure out what I wanted to be I got a job at a hospital as a phlebotomist (drawing blood). I worked early each morning and then went to school. It was a nice little routine and I liked the job. It was a technical job that you were either good at or not. I, thankfully, happened to be good at it.

A few months after I started I met Kenneth. He was in his late 60's and had already burried 2 of his sons. He had a lovely wife but was in ill health with a bad heart and bad lungs. He was deeply depressed about his sons' deaths and his health status. This was just one of many hospitalizations for him. I went in one morning to draw his blood and we started chatting. I could tell that he was a sad fellow but did my best to cheer him up. I then told him I'd see him the next morning. He resonded with "You were so nice to talk so much with me. If I make it out of here I'd like to give you a hug before I go home." So I told him that it wouldn't be an IF but a WHEN.

That night he took a turn for the worse and was transferred to the ICU. I didn't find out until I got to work that morning at 5am and went to get my bloodwork slips for my floors. I took the 500 hall and looked for his name but it wasn't there. My fellow phleb told me that Kenneth was in his pile in the ICU. We quickly switched around the assignments so that I could draw the ICU.

When I got to Kenneth's room in the ICU I was shocked at what I found. Kenneth, that I was just chatting with yesterday, was today sedated and on a ventilator. He had stopped breathing during the night and had had to be resiscutated. For some reason this affected me deeply and I started to cry right there in his room. He was light enough with his sedation to know that it was me who was drawing his morning labs and he too started crying when I told him that he would be getting that hug when he got off that machine and got better.

He spent a week in the ICU on the vent before being successfully extubated. In another several days he was transferred back to the 500 hall. Several days after that he was discharged home. And yes, before going home I got my hug!!

His wife thanked me profusely as apparently I was all he talked about once the breathing tube came out. He spoke of how he owed his life to me because he had given up and was ready to go and meet God until I came into his ICU room that morning and re-promised him that hug that we had talked about the day before. I became close to Kenneth and his wife after that and visited with them often. Kenneth used to call me his angel and always said that I had saved him. I always denied it and said he went overboard with it all but I knew that if I could make a difference for someone without any nursing knowledge then I could surely make a difference for lots more people with nursing knowledge. It did take me a few years and several more changes in my college major to figure this out but eventually I did get here.

As for where Kenneth is now.........honestly I'm not sure. I'm embarrased to say that too. This all happened when I lived in the south and I live in Connecticut now. I kept in touch with them for several years after I moved here but like all relationships, over time this one fizzled too. I imagine he has passed on by now with his medical history but with Kenneth you just never know. I do still think of him often though.

Thursday, May 22, 2008

All about me

I'm Tracey a 31 year old cardiac intensive care RN at a community hospital. I have been a nurse for 9 years now and have spent 7 1/2 of them in the CCU. Before that I worked in a medical/surgical/oncology unit. I liked the med/surg/onco but critical care was my passion. I didn't want to go there right out of nursing school as I wanted to get my feet wet before trying critical care. I'm glad I did it that way. It's not the right choice for everyone but it was for me. I have always worked the night shift. For the first about 3 years I only worked 11p-7a but then switched to 12 hour shifts 7p-7a so that I would only have to do 3 shifts a week. It works great for my family.

I'm an adreneline junky so critical care is my forte. I love the excitement of busy nights and patients that are quite sick. In fact, I would love to work somewhere that the patients are much sicker than they are here. I usually volunteer for the sickest patients in my unit. My co-workers are usually willing to comply too!!

Recently I applied for a new job called a critical care resource nurse. I have my interview Friday am. I was told that basically the position is mine and the interview is just a formality. This position involves doing all the emergencies in the building as well as rounding on the inpatient non-critical units putting out fires and keeping the patients stable or transferring them to the critical care units if they are unstable. Again..........just my forte!!!

I created this blog to write about the stresses involved in being a nurse, especially a critical care one. Though I am an adreneline junky it is a stressful job at times. Especially dealing with difficult patients, difficult families, confused patients, combative patients and worst of all patient deaths. I have sat with numerous patients while they died whose family wasn't there. Each one takes a small piece of my heart no matter if I'd known and cared for them for 5 minutes or 5 weeks. Death is a fact of life but not an easy one to deal with.

If you are interested in reading such stories then come along for my journey. You'll hear amazing stories along with sad ones, happy ones, and everything in between.

My Playlist