Saturday, July 31, 2010

Today... I survived

Today I left work in tears. 

After 12 hours of dealing with a patient in Diabetic Ketoacidosis, with blood glucose in the 800's on 35 units of insulin an hour.... with MAP's in the 40's and systolic blood pressure in the 80's....after giving 10 liters of Normal Saline. pH levels that barely reached the end of my shift.

Nausea and vomiting for hours.... after giving a total of 16 mg zofran IV.... With platelets dropping to the 40's and lab draws....every...30...minutes, because the glucometer couldn't even read blood sugars that high...

Yes, today I left work in tears... because after all of that.... my pages to the resident were ignored..... after all of that my request for something...... anything.... for his blood pressure was ignored.... after all of that I was chewed out by the resident because I "broke the chain of command" by paging the fellow.

Today I left work in tears. Today I am tired and broken and weary. But today I know...without a shadow of a doubt.... I did everything I could to advocate for my patient and in the end...tears or not... at least I have that.

Friday, July 30, 2010

A Day in Vancouver

We started off the day with a trip to The Crumpet Shop in Pike's Place Market. Great service and great crumpets with so much variety. I ordered a pesto, egg and ham crumpet and I was lucky enough to get an extra one with raspberry jam because the guy making them felt bad for the long wait we had. Awesome!

I loved this sign... and luckily I had my wonderful friend Helena in the passenger seat to snag a photo.
Crossing the Canadian Border!
Driving into Vancouver we noticed that my phone had officially informed us that we had been taken over by our neighbors up north... my AT&T internet service slyly became "Rogers" (Yes, we were nerdy enough to take pictures of it)

Driving through downtown... much is it? We were SO confused at the gas prices. I figured if I took a picture that maybe one of my blog readers could clarify?(Britt.. I was thinking of you here) :)

First things first...Dim Sum for lunch! It was delicious!

View from outside the dim sum place. BC is gorgeous!

Starbucks in Canada... in French and in English. No matter where it is or what language it's in... I heart Starbucks :)

Then we were off to Stanley Park... this is where we spent a good amount of our time in BC.

Absolutely breath taking! I could not get over how green the entire park was! Plus... for someone who loves rain like I do... I was in pure bliss with rain in the middle of June! woo hoo :)

Me and my partner in crime, Helena. Also, take note of my hat....
Yup... that's right. I'm sportin' a "Deadliest Catch" hat. :) Another great piece of "Deadliest Catch" goodness not pictured here.. I bought a kid-size, GLOW-IN-THE-DARK, t-shirt (I'm barely 5'1" so I can still fit in large, kids sizes). It literally has a glow in the dark CRAB on it! haha When I put it on in the hotel room the night I bought it... Helena yells with glee, "OMG you are everything I wanted you to be!" hahaha She's the best. :)

More Stanley Park...

We began the drive home and were greeted with amazing clouds and eternal green fields. I loved the drive from Seattle to BC.
Last but not least... we were lucky enough to catch this crazy, vivid rainbow as we pulled into downtown Seattle!

Thursday, July 29, 2010

Define Beautiful Project

One of my favorite blogs has a project for her subscribers.... to define beautiful.... what does beautiful mean to you?

I submitted a definition to her a week or so ago and she actually posted it today! (I had no idea until my friend Kelly told me that she loved what I wrote haha)

This is what I wrote:

I have been redefining my personal definition of beauty recently. Most of my life I have struggled to overcome my past. I had abusive parents as a child and was later moved between foster homes and different relatives. I worked my way through nursing school...18 hour days, 6 days a week for years. I have always struggled with self image issues...I am not by any means what any magazine cover would claim to be beautiful... but something that has been incredibly freeing for me is discovering that because I am a child of God ...I am deeply loved and am beautiful because I am God's creation....and that by definition is beautiful.

I feel beautiful every time I read the verse "I am wonderfully and fearfully made" Psalm 139:14

I feel beautiful every time I run, even though I hate running and am awful at it. The idea of conquering something I hate is incredibly empowering to me.

I felt beautiful the day I realized that the abuse I received as a child was in fact not my fault.

I feel beautiful every time I take a picture of something ordinary and it comes out extraordinary.

I feel beautiful every time I am out in nature and I see that the same creator who made me, designed this gorgeous planet.

I felt beautiful when I finally realized that no matter what weight I am or how much make up I do or don't wear or whether I am single or married... I am worthy of being loved.

I feel incredibly beautiful when I am surrounded by my best friends and I am overcome by just how loved I am by them. Seriously, words cannot describe how amazing the people in my life are.

I feel beautiful every time I am able to make a difference in my patient's life. Working in the ICU can be very difficult but knowing that I am able to give someone dignity and hope in what could be the worst time of their life is such a blessing to me. It is such a gift to show someone how valuable they are and how much they matter by the care you give them.

I felt beautiful the day I got my RN license in the mail because that day, despite everything that had come against me, I beat the odds.

I am a survivor and to me that is beautiful.

~Andi, On Call RN

You can check out the post here also! Her blog is a wonderful read :)

Wednesday, July 28, 2010

Patient advocate and so much more

If there is one thing I know about nursing it is that being a patient advocate is only the beginning of my job. This job has so many roles and because I work in critical care I think those roles are only expanded and magnified. Everything is intense...hence "Intensive Care."

In the process of feeling completely overwhelmed and burnt out, I had to step back and really evaluate a couple of things.... and the comments and responses I have gotten from people when I share where I am at as well. 

This month marked the end of my first year working as a full-fledged RN, and it has been quite a roller coaster, for sure. I think it is well known that in this profession, your first couple of years are the hardest and especially going straight into the ICU as a new grad, that inevitably throws a whole new mix of emotions and hurdles to overcome.

In the past month or so I have found myself dissatisfied with my job... disengaging from the things I once loved about nursing the most... patient care being the first thing to "take a hit" so to speak. I was increasingly frustrated and annoyed with everything that required me coming up with some form of compassion or understanding. I didn't want to deal with patient's families and I definitely did not have the patience to deal with people who were needy and difficult. Not in my character at all. And also really not good when you work in a place where everyone is very sick and very needy and therefore often times, very difficult to deal with.

Then, last week I was venting to a friend of mine, a woman older than I am and someone who has been a nurse for 12 years now. In the midst of the conversation she told me that I had a "bad temper." Not in a mean way...but in a "let me be a mom to you and try and help you way". I took it pretty harshly and in the midst of already feeling defeated I think it was a definite blow to my confidence and it made me question...

"Am I really supposed to be a nurse?"

Not that I was going to drop everything and decide to switch careers... especially after all I had gone through to get to this point... but it made me question whether the ICU was the place for me. So, I took a moment to step back and evaluate what she might have witnessed recently that would lead her to say this about me. I honestly don't see myself as one who has a bad temper and even my best friends agreed that while yes, I am a bit of a feisty, firecracker... I am not one to have a "bad temper."

Here is what I think I have come up with. In the process of being tired and overwhelmed and I think overworked... I lost something along the way. I got away from what I used to love about nursing and my job suddenly became about performances and tasks and not people. I have been focused on improving and not being the "flunky" new-grad that everyone dreads working with. The typical, work-place gossip began to overtake my job and nursing became more about bureaucracy and politics than it did about being a caretaker and an advocate. When you are tired, everything frustrates you and when I am frustrated... you see it on my face.

On the flip side of that I think there have been some real parts of my job that have been an external cause of my burn out. People have been calling in sick a lot and because of budget issues we often times don't get adequate staffing and because everyone from management down to the nursing assistants are feeling like there is a lack of support...everyone looses. The question I have been asking myself in the midst of this is...

If I am the patient advocate...than who is mine?

I don't fully know the answer to that yet, but what I do know is that I am supposed to be a nurse. My journey in becoming a nurse was something that was so divinely orchestrated... I just have to trust that I am in the right place. I have always believed that God gave nursing to me as my destiny and purpose and in the past week or so I have consciously taken a step back and literally prayed that I would be able to go to work with joy and not dread... That I would be able to love my patients and be their advocate and hope that God would be mine...

And you know what? Something did change... I consciously made the effort to give compassion and have patience and to listen, and I can honestly say that I don't dread going to work anymore. I am aware that I am in desperate need of balance... right now more than ever.... but I don't feel like it is completely unmanageable. It's a part of the journey into this crazy world of critical care nursing and I think its part of the territory for a new grad like me.... and really, in the end "this too shall pass" and for that I am so grateful.

Monday, July 26, 2010

The two dreaded words a nurse will ever face...

Burn Out.

I never thought I'd say it... well at least not this early in my career... but I feel it. Completely and all consuming. I am burnt out! I am tired and overwhelmed and despite the fact that I have had 6 out of the last 7 days off of work... I am dreading returning tomorrow. Partly because I will be working 8 out of the next 10 days....all 12 hour shifts.
yup, that's 84 hours of work in the next 7 days...

ugh, I just felt my stomach sink. Maybe its the combination of being short staffed and over worked and tired and feeling like I haven't had a lot of support recently. Maybe it's also a product of getting tired of the gossip that constantly floats around our unit.... nothing awful, just little bits of people's opinions that come out here and there. It's exhausting to deal with.

Anyway, it's why I haven't posted about my nursing life recently. My nursing life has been tiring and hard. Not exactly the kind of thing you want to write about when you are desperately trying to run from it at all times. I have been really enjoying diving into my photography and reading and getting good, quality time with close friends and new friends recently. 

As a matter of fact I just had an impromptu dinner party tonight that was such a blast! Pictures soon to come from that.... As well as a Vancouver post and a post on a big topic that has been lingering within my group of BFF's recently... being single.

In the meantime... if anyone has any tips on dealing with burn out in the work place... I'm ALL ears. 

Here's to a (hopefully) good week ahead!

Wednesday, July 21, 2010

Seattle Day 3!

The 3rd Day in Seattle was great because we took the ferry over to Bainbridge Island from Downtown Seattle. It's absolutely adorable with lots of fun little shops. The ferry ride was only 20-30 minutes and it's 7 dollars round trip! We ate at this restaurant right near the end of the main strip of downtown Bainbridge, right near the docks.
We walked along the little trail they had along the water and took pictures of the sail boats and the rock sculptures they had.

So peaceful... it made me wish I had the money to buy a house right on the water to escape to...such a quaint little town.

For lunch we had some great seafood. Calamari, fried oysters (YUM) and clam chowder. What a great meal it was too!

After lunch we headed back through downtown and explored some of the cute shops they had.
I loved the "heart" store.

We got tea and fudge and a bunch of fun things to eat for our friends back home. It was a wonderful Washington feast.

Since the order of my pictures got a little wacky I'll have to back track a bit so bare with me. :)
This is the view from the ferry ride.

Before we caught the ferry we walked down to the Bank of America building in downtown Seattle so we could go to the top and get Starbucks and check out the view.
On the way we came across this gorgeous church with a red door. I just loved it and had to snag a bunch of pictures.

On the right is the Bank of America building from the outside. On the left is the view. Can I just say this was probably one of the best pieces of advice given to us. For less than 10 dollars you can go to the top of the building to the view deck, on the 60th floor. There is also a Starbucks in the building that is on the 46th floor or something like that. The Starbucks has a great view too. Great thing about it though is that for half the cost of the Space Needle you get to see a view that is much higher than it! Plus you can see the Space needle itself.
These were just a few of the pictures from the top.
Next stop: Dinner on the Pier near the ferry dock. Had some wonderful raw oysters that literally tasted like ocean they were so fresh! I actually really miss them right now haha.

The gorgeous view from our dinner table. Right at Sunset
After dinner we walked through empty Pike's Place and took pictures before heading home for the night. Had to go to bed early cause the next day we were off to Vancouver!

Well that was our last day in Seattle. If you ever travel to Seattle definitely do the ferry to Bainbridge and skip the Space needle in place of the Bank of America building. One of the greatest tips we got. Eventually I'll get the pictures of Vancouver up here. I promise! Hope everyone is having a great week so far!