Good morning to you too ūüėí

Hi management, how are you? It’s nice to see you all bright eyed and bushy tailed. You’re coming off of a full nights sleep. You have quite a bit of energy huh? Sure you do. 

I don’t.

I just finished 12 hours of getting my ass handed to me. I’ve done two CT trips tonight. I got a sh*t show from the OR. I got yelled at by a doc for labs not sent from the previous shift. I finally ate this morning at 5 am and that was at the desk. 

You would know this if you came in and asked me how the night was instead of complaining about the cup at the desk without a lid. No, I haven’t read the email you sent because I haven’t had the time. Yes, the EKG machine is sitting outside a room. You know what else is outside that room? The code cart. It’s been that kind of night… But you wouldn’t know that because instead of inquiring about your staff you came in with complaints.

Maybe, just maybe you could say “good morning” first. Maybe you could take 10 extra seconds to get a feel for the unit and how the night was. Maybe you can look at what we accomplished instead of what we missed. Maybe you could manage to come in with a little positivity… Maybe….

I’m (not) a people person

I’m a people person… until I actually have to deal with people.

I know, I know, I’m a nurse. Dealing with people is pretty much all I do. However, I am an ICU nurse. I want my patients sedated and intubated. I want the families gone home for the day by the time I get there at 1900. I want to get my patient bathed, medicated, and ready for sleep by 2200. I want to be able to keep my patient comfortable and repositioned for my shift and up in the stryker chair by the morning.

I don’t want to talk. Am I good with families? Absolutely. Will I answer questions and make sure the family has a good grasp of the medical situation? Absolutely. Am I rude? No. I just really don’t want to do any¬†unnecessary talking.

I don’t care that your daughter is a CNA (congrats to her by the way) and told you what to be “on the lookout for” because you should “only trust doctors”. I don’t need to you come up to the nurses’ station to tell me the monitor is beeping, I can hear it. It’s beeping because he keeps taking his oxygen off and his sats are low, tell him to stop taking his damn oxygen off. I don’t need you to wake up out of your dead sleep in the chair in the corner every time I walk into the patient’s room to ask 14 questions that must have¬†obviously been really important. It’s great that you know *insert important person here*¬†but you don’t need to try and name drop every time I come in the room. I get it. You are the beautician of the CEO’s wife. Ok… I am not going to treat you any differently as I give¬†all of my patients A-1 care.

I really, really just want to be left alone to take care of my patient. Is that too much to ask?

Alarm fatigue 

I am legitimately over it. We have new GE monitors and they beep for EVERYTHING! Apnea is a triple beep but an arrhythmia isn’t. It doesn’t read the respiratory leads well so everyone is either tachypneic or breathing 6 breaths a minute.   There is something beeping every minute it seems. It’s getting to the point that we are starting to ignore the alarms because there are so many of them. 

This is what they mean when they refer to “alarm fatigue”

Story time no. 8

I decided to actually check my work mail box. Amongst the numerous papers that I’ve totally ignored I found lots of little shout outs and even a few gift cards from patients and coworkers.

I don’t think people realize just how much little things like this mean. It makes us feel appreciated. It makes me feel appreciated. It shows me that I’m doing something right…

Story time no. 7

Had my follow up appointment for my back today. The MRI shows I definitely herniated a disc between the lumbar/sacral region. No nerve involvement so no surgery. Yet. However, if the disc continues to degrade then surgery is where we are headed.

So now this puts me in a weird mental space. Do I continue being a bedside nurse, knowing that I’m going to potentially hurt my back more, or is it time for that cushy office job where I’m not pulling patients? I love direct patient care. I love being at the bedside. My back, however, is not in agreement. I’m a trauma nurse, I’m going to be pulling and tugging. It’s inevitable. My coworkers have been AMAZING at trying to help me out when they see my back is causing me pain. They opt to take the “pulling side” when we turn so I don’t have to strain myself. They put me at the head of the bed holding c-spine so I’m not having to do a whole lot. They have really “had my back” so to speak.

But it’s not fair to them. They shouldn’t have to potentially hurt themselves so I don’t hurt my self any further. I’m starting to feel like a burden. I don’t like that.

So now it’s time to make some big decisions…

Story time no.6

Sitting at the front nursing station when the door rings.

"Delivery for STICU!"

Delivery? It's one in the morning, what the hell is being delivered at one in the…

Oh.

Ohhhhhh…

THE LEECHES!

He's delivering the God forsaken leeches!

I am thoroughly grossed out. I hate leeches. I hate them with every fiber of my being. I can't touch them. I don't even want to look at them… but I need to open the box so we can put the squirmy bastards in their refrigerated tanks.

I managed to open the box. As you can see, I even managed to pick up one of the bags.

That's as far as I got.

Dude was far too squirmy and I was far too grossed out to do anything else with them. God bless our tech for being able to grab the box and take them away from me so she can put them away.

I'm a horrible charge nurse. I'll take that. I'm not touching those bastards though…

Hello nightshift, goodbye normality

I am a nightshift nurse. I have been my entire nursing career. It’s what I am used to and it’s been great for me. Key word: been. I used to love being a nighshifter. You couldn’t get me to work a dayshift if you paid me extra. 

That’s changed. I’m old now. I’ve been a nurse for 7 years, that’s like 21 years in human time. Nursing ages you, quickly. I’m tired. I’m always tired. That’s the problem with nightshift, it goes against your natural rhythms. I’m not supposed to be up wiping ass at 0241 in the morning and yet here I am doing just that. I can’t just have one shift off in between nights anymore either. It’s impossible for me to get anything done because I’m so exhausted that I sleep the whole day away. I’m lucky I live in a house and not apartment because I cannot tell you how many times I have been up cooking and cleaning at like, 2330 at night as if it’s normal. When I have a stretch of days off, I fall back into a normal rhythm, up during the day and down by 2200-ish. That first shift back after a stretch off is BRUTAL. It’s getting harder and harder to adjust back to the nightshift life. I think I may be reaching the end of this “nightshift nursing” thing. Then again, my mouth is far too vulgar for dayshift so… 

Story time no. 3

You ever have a patient situation hit you hard? It’s happening to me tonight. 

We have a patient going down to OR for organ harvesting. The patient had a severe fall with non survivable injuries. The family had the heart, the soul, the strength to say yes to organ donation despite the sudden death of their loved one. 

It’s hard to watch. It’s hard to see the children say their last goodbye’s. It’s hard to see their tears. It’s hard to listen to them thanking us profusely when we should be thanking them. It’s hard knowing that this is the last time they will see their loved one, connected to IV’s and intubated. It’s just painful. 

I know that this patient will bless someone else’s life. They aren’t dying in vain. I just wish they weren’t dying at all… 

Resting bitch face

I have resting bitch face, also known as RBF, and it’s terminal.

I have been told in my annual evals that I need to work on my “non-verbal communication”. Translation: “fix your damn face woman!” I blame nursing for my RBF. You probably have it too.

I am not only responsible for collaborating with the family of my patients, but also with the interdisciplinary team. Have you ever had to deal with a family member that¬†insists that you know that their “cousin/sister/brother/daughter” works in health care, as if it is going to change how you care for their family? ¬†It happens faaaaaaarrrrrr too often in the ICU. Typically my reaction is this:

waka ok

I am glad that your cousin is a CNA in a nursing home. Really, I am. However, this is an ICU and things are a tad bit different here. My other favorite is when I have to talk to one of the residents about something I need ordered, and instead they want to peacock around and tell me why they don’t think it’s necessary DESPITE the fact that the attending has already agreed that what I want for my patient would be beneficial. Once again my facial expressions look something like this while they are over-explaining things:

nene eye roll

Look, bruh, I know what hydralazine does. I know how it works. I am asking for it because I need to control his BP but his heart rate is like, 58, and¬†maybe metoprolol isn’t the best idea. AND I ALREADY ASKED THE ATTENDING ABOUT IT WHEN HE WALKED THROUGH THE UNIT DOING HIS ROUNDS, just give me the damn meds!

Yeah. I have yet to figure out the whole “poker face” thing. Seven years of nursing and I will still look at you like you’re stupid.

So, to my new nurses, just know that if you don’t have RBF, you will. It won’t be on purpose. One day someone will say or do something so dumb that you just can’t hide your feelings. It is normal. Just about every nurse I know either admits to having RBF or has had a coworker with RBF. It just sort of happens. Don’t beat yourself up over it.