I think the title says it all.
I just finished my second full week of being off of orientation. I learned a lot.
My first week I had two stable flip and feed kids. That was nice. Boring but nice.
This week I had one stable ventilated kid (these are my favorite kind!) and one that was still in the incubator and on Optiflow. Needless to say, I went up in acuity, but not by too much.
Day one was OK. No major changes in my kids. Day two was a roller coaster. My intubated patient got extubated and my one on the optiflow bought itself CPAP/Hudsons.
The fellow that had my intubated kid asked me a couple of times if I thought it was ready for extubation. I answered very honestly, I don't know. I really don't know. That's not a good feeling. I'm not a fan of not knowing.
So I asked the RT that was there that day what she thought and she felt the same way as I did. I was leaning toward not ready.
Then toward the end of the shift, my other kiddo started to retract. Did I catch it? No! I felt so terrible for not catching on to that. The docs ordered a chest xray and blood gas. I was looking at the kid thinking that they were going overboard with her. CXR, OK but a blood gas on someone who is not intubated and not showing major signs of respiratory distress? So I blew it off thinking it would be nothing.
I never heard back from the resident about the results of the CXR. In our unit when we don't hear back, we assume no changes and go on as such. Come to find out the next day, that the CXR was pretty whited out and the kid got a dose of Lasix because of it. They were also put on Hudsons. Finally, something I can understand and rationalize!
Day three I have the same assignment and was also first admit. Now that is scary because you NEVER know what you are going to get. You could get the baby(ies) everyone has been talking about for a few days or you could get the walk in crash c-section. You just never know.
Luckily I got a transfer from another unit so it was a best case scenario rather than a worst case.
This was a term kid who came to us because of an ABO incompatibility. Basically this baby's body was attacking it's own blood cells and rupturing them which was causing the bilirubin levels to increase very rapidly. If not treated, this is deadly
When I find out what I am getting, I start warming up my bed and getting things together such as supplies to start an IV, a bag of D10 just in case they want to hang fluids, and whatnot. The kid gets there, the bed is warm, and I'm ready.
The admission goes really well since it's a transfer. An hour later, after the kid is settled in, another nurse comes over to me and says that we probably don't need to have the radiant warmer on. This was a term kid under a TON of bili lights. As soon as she said it, it made total sense. Did I think of that before? Of course not!
I had to hang a med I've never given as well so I went to read up on that. When the med came up, it looked like some had been shaking it the whole way here. There were lots of tiny tiny bubbles in it. So I put the syringe on end to get the bubbles to the top. Apparently I missed some. I went to luch after the infustion started and luckily another nurse caught a pretty big bubble in the tubing before it got to the baby.
I've just had so many "moments" lately. I'm amazed that they keep letting me come back.
One of my saving graces is that I have a charge nurse who I work with very frequently, who has a lot of confidence in my skill and tells me this frequently. I don't know how I would go on without her support and the support of the person who precepted me the last half of my orientation. They are people put into my life by God. That's the only way I can describe them.
I also try to remind myself that all of these wonderful and knowledgable nurses I'm surrounded by didn't start out this way. They all started out in the same place that I am now. They are wonderful resources and I love being surrounded by them because it's a constant reminder that if they can, so can I.
This will be one of my most random blogs so far. I just feel like blogging since it's been a while. Usually when I sit down to the keyboard, I already know what I'm going to write about and in which order I will put it down. Not this time! I know I need to write but about what, well I guess we will find out.
I don't remember if I've written on here since I've been on my own. I have now been on my own for one week and tomorrow, Thursday, will be the start of week 2 of being on my own. I enjoy it. It's also very different. I'm debating now if I want to try to take an admission yet. The reson behind it is because I want to do an admission on my own before I forget what I learned during orientation.
I do know for sure I would like some more acuity. So far my assignments have been easy flip-n-feeds. Of course now that I said that.........it will be interesting to see what I get tomorrow when I go in.
On Saturday, September 18, I tested in Tae Kwon Do for my green belt. It was a really awesome day! I didn't sleep well the night before thanks to caffiene. I was so exhausted when I woke up Saturday morning. It was a miracle I remembered to bring everything with me that I needed to!
There were three people testing for green belt. John, myself, and a kid from another class.
It started with Mike asking all of us (there were about 15 of us total from white belt up to where we were, yellow belt-green tip) if we were nervous. I think all of us raised our hands. He then told us to try to relax. He said that if he thought that we weren't ready, we wouldn't be there. Very true.
We started off with our forms/patterns starting from the most basic up to Do San. As everyone completed the pattern of their level, the were able to go sit off to the side. The same thing was done for our required kicks.
Our required kicks were a leading leg hook kick, vertical kick (I like this one! It's like a front snap kick, same chamber, except your target is at a 45 degree angle from you), and a jumping back piercing kick. This is the one that was causing me the most distress. I feel like I'm getting better and more confident in my jumping skills but know there is still room to improve.
I messed up a little bit on the required knowledge. I knew everything I needed to know, I just put it in the wrong order.
Another of our requirements was to reach 120 degrees on the split machine/stretcher. He wanted us to go as far as we could and I was able to go to 173 degrees! Next testing my goal is to be at 180 which is not the full splits but very close.
We also had to do the dreaded pushups, squats, and crunch test. This was the hardest part for me. We had two minutes to do each individual exercise. I rocked the squats with 74 in 2 minutes. I managed 44 full situps in 2 minutes. It's the pushups that killed me. He gave us a small dixie cup that is about 2 inches tall and we had to touch our chest down to the cup every time. Needless to say, I managed 32 or 33 pushups in the 2 minutes. My required number for all of them was 30.
So now my goals are to do 100 squats in 2 minutes, 50 situps in 2 minutes, and 40 pushups in 2 minutes. The idea is to be able to do this at the next testing time which is usually every 2-3 months.
My break kick was a jump side piercing kick and I'm so proud of how well I did on this one! Mike came up to me while I was getting tested for knowledge and told me if I wanted to try breaking 2 boards I could. My requirement was 1 board. I hadn't really thought about it before then but decided to go for it! The worst that would happen is I would go down to one board which was my requirement anyway. I figured it was worth a shot!
Mr T sets me up on the breaker and helps measure me. I got myself all set up and BAM! went for it! I ended up breaking the two boards on my first try! I was so excited about that! That was the best part of the whole testing experience for me!
During practice, I always used one board. We have rebreakable boards and I was using the brown board which I would only break about half the time. That's why I was so surprised that I broke two real wood boards with my first try!
As we finished up, we all lined up to shake all of the judges hands. The judges for our testing (colored belt testing) are all black belts in our school. Mike's was the first hand I shook and what he said to me is still in my mind. He told me that I was looking very good out there. That combined with how he said it just totally made my day! I've been working very hard, giving everything in class and still practicing at home, and to be recognized for improvement like that means a lot to me.
I'm not trying to sound egotistical here but I feel I've finally found a sport that I enjoy from the bottom of my heart and that I am successful at. It's like finally finding that perfect shoe! You know, the one that makes your legs look great, feels good on your feet, and just looks really good. It's perfect.
I know I still have a lot of work to do and lots of room to improve. I'm looking forward to seeing how far I can take this.
Cross your fingers for me. I am hopefully going to a tournament in Portales, NM the first weekend in October. I sureh hope there is competition there for me. This will be my first tournament since I was a white belt with a broken elbow!
Ki-yap!
I just completed working 5 days in a row. That's about 60 hours. I'm exhausted. Don't know how I did it but I don't EVER want to do it again!
Anyhow, Sunday and Monday were my first days off of orientation. Sunday was really ackward. I'm sure my podner didn't help the situation out much but either way it sucked and I had convinced myself that I failed. I didn't break the kids and got everything done but I just felt like I didn't do as well as I could have.
I felt very lost not having my preceptor there. I felt very lonely as well. I normally work the end of the week and the begining of the week has a whole different set of regulars. I only knew a few people that were working.
When I got home that night I couldn't decide if I wanted to throw in the towel or not. I didn't feel good about what I did and how I did it. Even though nothing went wrong, I felt like everything went wrong. I can't really explain it well in words. Wish I could.
Monday went much much better. I felt more comfortable standing on my own two feet. I had a pretty good podmate who was much more friendly than the person I was with on Sunday. It was just better overall. I was even comfortable helping out my podmate with her kids when she got an admit.
Between both days though I would have to say it was successful. I'm scared to get an admission on my own but I'm getting there. I'll never know how it will go until it happens.
Yikes. Just yikes.
This is the official start of my last week on orientation. I can't believe how fast the time has gone! It feels like I just started yesterday. I still have so much to learn! My favorite quote is still "The more I learn, the less I know." I wish I could remember where I saw this at and credit the person.
Anyway, my time off these past few days has been quite productive. On Saturday I went to a yoga class. I hadn't been in quite a few years. Unfortunately it wasn't the same instructor as before but it was still a good class.
Sunday I did Body Pump at 10am followed by a 25 mile bike ride for which I felt horrible on. We stopped about halfway so I could refuel. Guess if I do that again, I'm going to bring some real food with me. Sport beans just didn't cut it that day.
Today I rested. I was supposed to go up to Santa Fe and ride with the new riding group but after yesterday's fiasco, I opted out. After yesterday's ride, my lungs felt like sandpaper and it continued until after I fell asleep. Thank you asthma.
I'm still sore today and am walking like I'm 80.
I did some stretching this morning while watching Sherlock Holmes. After the movie we went out and did errands. I got the car cleaned, we got ice cream, then went to Sam's Club and Sunflower.
Here it is at 8:30 tonight and I'm still working on dinner. I'm making spaghetti squash and ratattouie (or however you spell it). Either way it's taking FOREVER so it must taste good.
My week coming up at work is going to be insane! I take a STABLE certification on Thursday which is 10 hours and then I work Friday and Saturday, my last two days with my preceptor, and am then on my own on Sunday and Monday.
Scared doesn't even begin to describe how I'm feeling right now. I am actually quite beside myself about the whole deal. For one, working 5 days in a row is just insane when you work 12hr shifts, and two, I can't believe they are going to put me out there on my own! Me! I'm a brand spanking new nurse who has only been there 4 months and they trust me enough to put me out there on my own! The thought just makes my heart race!
A part of me knows I can do it but the other part of me doesn't want to let go of what I'm used to. It's really nice to have someone available to help you out when you back yourself into a corner. It's also super nice to have someone there who is willing and has the time to answer your questions.
Just the other day at work, I had to change out fluids which can be quite the partaking in our little world. After that, I had to re-zero the arterial line to make sure I was getting a good waveform and proper pulse and b/p readings. I knew I had to hook up a syringe without the plunger in it but for the life of me could not remember which way to turn the stopcock to get it to read right! I asked my pod partner and she told me to turn it off to baby. Well as soon as she said it, I was like "duh! that makes sense! I KNEW that! If I did it any other way, the baby would bleed to death!" I felt like such a dummy.
Then I had another dumb moment as I was changing the fluids. I had all of my lines primed up to my transducer for the art line and then I got stuck. We have these connectors that are like male/female connectors and when I got to my stuck point, I had two female connectors in my hand so I grabbed my preceptor and asked her what I did wrong in prepping the tubing. Come to find out, everything was done correctly, I was just holding the end that was supposed to go to the baby! Doh! No wonder it wasn't fitting! I had the wrong end of the transducer in my hand!!! I laughed so hard at myself!!!
I have to note that these two situations were after my preceptor was already speaking good of me. Then I go and do somethng brainless like that! Gooooooooooooo me!!!!!!!!!!!
and they think I'm ready to be on my own. ha!
