Thursday, October 27, 2016

New Graduate Residency (NGR)/Nurse Residency Program (NRP)

So I got an email yesterday from the NRP human resources (HR) personnel indicating that they were trying to reach me and had left me several voicemails. On friday I had received an email that gave me an idea that they might be giving me some good news sometime soon - at least thats what I was hoping for.

But I had completely forgotten that our cellphone broke just last week and didn't think about the fact that I didn't have access to voicemails and that ppl would be trying to reach me. Additionally, the HR person and I had always emailed one another and so I didn't think that she would try to reach me by phone - such a blonde moment!

So I emailed the HR person and explained what happened with the phone and gave an alternative number. But in the evening I questioned hubby about whether we could retrieve the voicemails - so we were able to get that to work and I heard what was said.... not much other than that they had "good news" for me and wanted to talk to me about it on the phone. Well while we were listening to them I then had an epiphany about whether we could forward the cellphone to another phone ***without using the cellphone because it was broken and wouldn't even turn on. We contacted our phone provider who helped us through that and now it's forwarded.

This morning the HR person called me and offered me a position with a brand new NGR with their pediatric/PICU!!!! And they're also going to put me through L&D/post partum and NICU so that I can do shifts in this area if need be!!! OMG I'm ecstatic. I NEVER thought in a MILLION years that they would consider me for that area because I don't have extensive clinical experience in peds and no experience in PICU - only through the ER and so I never thought that they would offer me this NGR. I'm so excited I can't even explain it.

When I did my interview, they asked what area I was interested in. I told them that I was pulled in two - one way being my passion and hearts desire to work in peds/NICU/PICU which I had PERSONAL experience with but little to no clinical experience in these areas, but felt that I wanted to work in those because I could relate a bit to what parents are going through when you expect a healthy baby and they end up in the NICU instead and then the flip side where I have the clincal and work experience in adult care which lends well to the critical care NGR. After this the interview continuued on like it normally would - but the questions were generic in nature and didn't ask me to talk about how my peds/ER experience would lend well to the NRP I got offered. Either way, doesn't matter anymore, my hard work and perseverence is paying off big!

Now that I've been offered this, I have to get my butt in gear and finish my program off as strong as I can and get prepared to write the NCLEX ASAP!

Monday, October 24, 2016

3 wks out of the game

A lot has happened, which is why I've been MIA.

Last night I had my MASSIVELY IMPORTANT ATI test - the comprehensive predictor test - the one test in my ENTIRE nursing education that matters. If I don't pass it, I fail my course (if I fail the second attempt that is) and have to repeat the course, which would then push my graduation date and would screw up my current GPA of 3.5!

So I've been busy studying for that thing - which I PASSED!!!!!!  OMG what a weight has been lifted! And because I passed this, arrangements can FINALLY be made for us to get there for the pinning ceremony (evening before) and graduation. My husband has purposely not allowed him nor I to get excited about the upcoming graduation because this one test would decide my future. Now that I've passed it, you bet I'm being ecstatic and seriously want to scream it from the tip top of this new house.

Oh ya, did I mention that we moved into a new house? Probably not, considering I've been a bit busy. But never the less, we moved. I don't really like the new house. I wasn't consulted before an offer went in. I hate that there isn't two separate living room areas that are enclosed somehow so that the sound from one won't interfere with the other. It's incredibly frustrating. Plus I was promised my own bathroom with a shower. Ya, didn't get that one either! I got a sink and a toilet and a shower I am told I can't use because the glass isn't installed yet. But my wants and desires are always put on the back burner in this family so who am I to say anything!

On a different note. I've applied for a bunch of nursing residencies. For every one that I applied to I've been contacted for an interview for. And for two I've been asked to go to their hospitals for interviews/match day. And for the one that I was actually able to go to for an in-person interview. Then just the other day I received an email from the one place I did the in-person interview with that attached an "employee benefits package"!!! So I'm hoping that this is a great clue that I'll be getting an offer very soon!!!

I really, really hope that it's critical care; even better would be NICU, but I doubt it. Either way, I would still take this position though, it would be quite the experience. This one hospital alone has SIX, count em six ICUs!!! Plus they have 5 other hospitals that I can transfer into after the fact. Perhaps I can get into PICU or NICU afterwards.

As great as these parts of my life have been my work life has suffered BIG time. So my IIH is still a major issue. Whenever I work I either end up with a migraine during the shift or the next day. Friggin sucked! And considering I'm not going to work while on narcotics, I needed to have my shifts spread out. So I couldn't work the "required" weekend like my collective agreement states I need to be doing every other weekend. So my physician noted that I need to have at least two days between my work days. But otherwise, I can work the required jobs that a nurse does. But when my Occupational health person got my medical documents and talked with my manager who indicated that that wasn't an option on our unit. SUCH BULLSHIT!!!! The other unit my manager is responsible is closed now due to renovations and such and so all the nurses from there are transferring into our unit - so it's not like there's a shortage of nurses or anything - ones who would be able to work those shifts that I can't!!! So I'm off work now because my manager won't agree to me working what my medical documentation indicates I need to. Plus, the Oc Health Dr wants to meet with me to discuss my IIH and how I'm impacted from it (assuming so since I don't actually know). So now I have a meeting with this Dr on thursday. Kinda pissed that I have to go through this kind of BULLSHIT.

Another piece of BS that I had to deal with was trying to get my daughter started at her new school. OMG such a process!!!! They need documentation that you bought a house in their district, but also require a bill in our name (which we wouldn't have received for another 3 wks!!!) - but won't take house insurance!!!! I wanted to scream at that about the idiocy of their policy. After a bunch of "going over the heads of the lower ppl to get to the ones who make the decisions" we finally got her started. Then on Friday I was told to come pick her up early from school because she had head lice - AGAIN!!!! So I treated her before even seeing if she was infested but when I combed out her hair with the little brush, there were NO nits or lice. So ya, kinda pissed about that. And they also make you go to your physician to get cleared and get documentation that there's no infestation or they can't go back to school!!!! So guess what I have to do in the morning?!

So ya, I've had a lot going on these past couple of weeks. I'll try to remember to tell you all about my nurse residency adventures. My life, as always, is never boring.

Friday, September 30, 2016

Working hard

I started back at work. Yaaaay! Only 7 mos away! Geeze it took a long time.

My first day back I worked alongside a co worker => ended up with a migraine half way through! Thankfully my migraine med worked and I didn't have to leave work because I needed to take morphine to relieve the pain.

My next shift I was kicked to fend for myself. And WOW what a shift!

At first it flowed well. I had a flow down. Plus there were some nursing students that were paired with ME who I could delegate some tasks to. Too bad they were only there until noon. ARG all by myself. Goodness I thought I was falling out of the nest and having to learn to fly while falling 50 ft to the ground. I felt inept for sure.

Then of course the shit hit the fan after one of my patients (who got thrown on me because a nurse called in sick! - go figure) had physicians coming out of the wood work, popping up and saying that all these stat things needed to occur.

A little back story: my patient ended up at our house because my patient was found by family with what was thought coffee ground emesis and so EMS brought her to MY hospital. Oh ya, and her GCS was 7. But for who knows what they were thinking, did not think stroke considering all signs pointed to stroke.... who knows why though. Since our sister hospital is the regional stroke hospital she should have gone there and not ended up under my watchful eye.

So when I had this patient I was definately thinking stroke - pt was COMPLETELY obtunded with a GCS of 4 - she only responded to pain and certainly couldn't obey commands. She was posturing. Every sign pointed to stroke. But she hadn't been diagnosed with having had a stroke.

The head CT that they did didn't show a stroke - a bleed anyways, which would have shown up on the head CT but if it was a thrombotic stroke, it sometimes takes up to 24 hours to show up.

Back to my story...
So GI came to the unit to see the patient, did quick questioning to the daughter who was there and of me and what I have observed while caring for her. So he decided almost immediately and said "ok, I'm going to take her to scope her in ten minutes if that's alright with you" - the daughter of course said yes... then not TWO minutes later did a porter come in the room saying that she was picking her up. I was completely shocked and thought that she was going to surgery. And when I made a comment in regards to that the porter indicated that she was taking her to CT.... which perplexed me because I hadn't heard this in report and hadn't seen a physician so I had no idea what was going on.

Of course I helped transfer her onto the stretcher then asked the porter to wait at the nursing station while I figured out where exactly she was to go to first. I headed straight to the charge nurse to find out what they knew about this all. Well turns out some physician had decided to order a stat head CT - but this patient also needed to have things figured out and needed to be scoped because she had certainly bled out of her mouth and I had provided extensive mouth care and didn't see a cut to the mouth to account for how it looked. But she also really needed this head CT. So it was decided that she would go to be scoped first then to CT and back to us.

Before the patient got back the neurologist showed up and questioned me about the patient. I indicated that I was a neurology nurse for five years and thought that she had suffered a stroke. But told him that it would be good for him to lay eyes on her himself and asked that I contact him. I asked if there was a way to get a hold of him in particular and he actually gave me his pager number. Surprising considering most physicians say to just call locating and contact him that way. Of course he's gone like 5 minutes and the patient returns. So away I went and paged him and he came so quickly!

Once he laid eyes eyes on her, he completely agreed and even said that he thought that it was possibly be a brain stem infarct because of the posturing - the oddity being the fact that her legs looked like this:

The patient had the first position, which is supposedly a indication of brainstem infarct. So he wanted a stat MRI because the head CT didn't show anything.

Of course while this is all going on I'm having to discharge one patient, deal with another patient who had massive wound issues and the wound care nurse needed me to go with her to do it. Plus another pt that I had to manage - who needed bladder scans q4hrs which of course meant doing In&Outs 3 times in my shift. Not included this is the regular duties - meds, bathing, etc...

So when this all went down I was up the crick without a paddle. Thank goodness for my buddy who offered to take a few things off my shoulders so that I could take a break and decompress a bit.

Crazy thing about all this..... MRI did NOT show an infarct anywhere in her brain, or brainstem for that matter. So nothing to account for her neurological status and clinical symptoms. But where I stand - I know that I did all I coud to keep her alive and well. Who knows if it stays that way, I hope it does, I know that it would destroy her family if that changes.

Friday, September 9, 2016

I'm in pain

So for the last two days I've been dealing with a pretty bad migraine. My meds don't seem to be helping either and so I've been struggling. It's hard to get stuff done when the pain is like this - when my head feels like it's being squeezed it's hard to concentrate on what I need to get done for school.

I have a "ways of knowing" paper, I'm about 3/4 of the ways done but my brain isn't really computing because the pain is so bad. I just feel like sleeping a whole lot - it's kinda how my body deals with pain. I tend to sleep quite a bit so that I'm not experiencing the pain.

I'm just thankful that little tyke started school again so that's been keeping her happy, if not a little bit more tired. Her first day you could tell that she was exhausted but by golly she would not go to bed any earlier than 9pm - come hell or high water! Surprisingly she made it to then and then completely crashed! I only wish every day was like that. Unfortunately, I know that won't last, give it another week and she'll be used to getting up early and the energy expenditure that occurs when you're at school with your friends. Bonus is that little tyke has said that she loves her teacher. Hopefully that means that she'll have a good month because with the move that means that she's switching schools and therefore will receive another teacher. So we'll see how well she copes.

With this migraine I really don't want to be staring at a computer screen any longer than absolutely necessary - so I guess it's nap time for me.

Monday, September 5, 2016

Trying my best

It's been a little over a week since I had my surgery. It has its good moments and bad - times when I think I may have an infection but then I'm unsure about what color discharge should be seen considering where the surgery was. I have follow-up on the surgery in a couple of weeks so we'll see.

I've been trying to not aggravate the area so I've pretty much been reclining or laying on the couch and getting my school work done. Boy I can't wait for this semester to be over, and it only just began last week!

Our prof has us doing our NCLEX prep stuff differently than what is normally done in which you study and then take the tests/quizzes. Well she has us doing the quizzes/tests without any studying so that we find out where we're weak and therefore need to spend our time studying THAT stuff. Her way makes sense, just wish she would have explained this at the very beginning. Oh well, c'est la vie!

I'm below where I need to be for the HESI but I know that I can get to where I need to by going through this process. I certainly know I have a bunch to relearn/remember from the paeds and OB course that were tested out of like 4 years ago!!! So it's not like the information is fresh in my mind or anything. I also suck at remembering cardiac stuff (Lt vs. Rt heart failure) or all the values for cardiac stuff (cardiac output, atrial pressures, etc...) or ventilatory settings - the norms and what you would do when they are off and such. I also suck at remember cranial nerves  - even tho that's where I worked for like 4 years!!! So bad!!! I also have to go back and remember developmental milestones & stages as well as immunization schedule (FYI they're different for Canada vs. the US!) so I guess I'm going to have study study and study some more. But at least I know where my sucky areas are.

This week and next week I have major papers due for the other course so I'm going to be busy plugging away at those. Nice this is that little tyke starts back up in school in 2 days time which means she'll be in a regular routine and I can stay awake all night long like I normally do without feeling bad that I have to sleep at some point during the day - at least while she's in school she's away and doesn't care that I'm sleeping.  Yay for little kids schooling!!!! Now back to studying....

Saturday, August 27, 2016

It's done

I had my surgery yesterday. I was quite nervous for it actually. I didn't know what would happen until I was under general anesthetic and could be examined that it would be decided upon.

We did the pre-op and it took FOUR HOURS!!!!  Goodness that was the longest pre-op process that I have ever been through. I would have expected that from the hospital in my hometown but not at this major city's hospital. It was ridiculous.

First I had to see a nurse and tell her what I was having done. Then she decided that I needed to have blood work and because of one of my IIH meds (diamox) I needed to have a ECG -> which showed that at one point I may have had a heart attack so then once I had those done I had to see a physician (after sitting around for somewhere like an hour and a half) and he kept asking me whether I have any chest pain or whether I can go up two flights of stairs without huffing and puffing. I indicated that I could and it seemed like they didn't quite believe it because they asked the questions just in a different manner. Plus I had to repeat all the same info I had told the nurse which I understand why they do it but I don't see why they don't just verify the information and ask if anything was missed or forgotten. He also asked about my IIH and I had to sign a release of information for them to get the neurologist's last progress note. So then I went and waited for another hour+ to see the next person.

Then I had to see an anethetist and repeat ALLLLLL the information all over again. And surprisingly enough they had the neurologist's note and so I had to discuss how I learned about that. Then I learned something new....
Succinylcholine (Sux) increases intracranial  pressure and should therefore indicate that it needs to be avoided. So I asked whether there was a chance that she would be my anethetist.... which she gafaughed and said "well there's 38 of us so it would be surprising if you do".... well guess what?!

I got the same anethetist!!! Rather shocking. Said that instead of Sux she would be using rocuronium (rock). She also had a teachling who said that once on the table she would give me some ativan - yay!

But HEEELLLLLLLL I woke up with a MASSIVE migraine!!!!!!!! Geeze my head hurt. But surprisingly my butt didn't! I was told that I received a fistulotomy. That it went smooth and exactly as planned. It was the first time in THREE years that my butt didn't hurt (well it was about 2/10 pain wise which for me is no pain really). I was sooo impressed that my butt wasn't the main bit that hurt.

Then I was given morphine on an empty stomach (bad idea!!!) and after I was out of PACU they wanted me to go pee which was harder than you think! They wouldn't let me go until I peed. However, I was extremely nauseous and just after I washed my hands I vomitted into the sink - OMG I couldn't believe it. I was so caught off guard, I couldn't even make it to the toilet 2 ft away!!! Thankfully when I exited the bathroom they had a basin that I could take with me back to my little corner and vomit along the way and lay down into my bed. Ugh I was so nauseous. So my nurse gave me a med to try to help me not vomit. But it didn't help. So I pretty much told my nurse that since I was out of options for meds to take to control the vomiting, I opted to be discharged so at least I could vomit in the privacy of my own home.

I came home, took a couple of my own meds (like zofran) so that I could feel better. Then went straight to bed and slept a whole whack load of hours. And when I woke up I wasn't nauseous OR in pain. It was glorious!!! Now for the healing part. I hope it goes accordingly so that I can go back to work and life and be able to exercise again!

Saturday, August 20, 2016

Getting ready

Next week is my surgery. On tuesday I have pre-op, then I'll learn what time I have surgery. I'm kinda nervous about it all. Going into this surgery I don't know what I'll come out of at the end of it. I'm sure hoping that this time next week I'll be over and done with.

And while I want to be optomistic, I've seen firsthand that that's not the way it always works out. I had a patient last year whose buttocks were a mine field of fistulas... I'm worried that I'm dipping my toes into a puddle I don't know the depth of which I'm getting into.

I'm just hopeful that I heal properly and that I don't have to worry about this issue any further.

And next week I also start the 'final' semester (good lord I sure hope that it's the final) - I'm getting a running start at it b/c the prof opened up the course already. It's going to be a doozy of a semester too. The other course is all about ATI, NCLEX and Kaplan - holy heck it's going to be a lot to keep my head above water. Plus I'm supposed to go back to work after I heal from this surgery.

Then we're supposed to move in the beginning of october. Hubby just asked me the other day what day I want to  move on. Problem is that I have a major paper & presentation due that week and so there's no way that it can be done that week - or it won't be a lot that I'm involved in. Good thing is that we're going to be in possession of both houses and so it doesn't really matter when exactly we move either than the fact that we're supposed to cut the utilities and internet here to move it to the new house. Unfortunately, I need the internet in order to submit my stuff so I don't know how we're going to work that.

Plus I'm sure that moving will add stress to my already stressfull life. Hopefully I can handle it all.