A day at the hospital...my career in the making

So I was scanning my brain for blog ideas and a phrase I always hear came to mind " I didn't know a nurse did that". I don't know why I thought of this, but I did, and from thence sprouted my post. I thought I'd share what I did in a typical (well no day is ever typical), shift at the hospital. I'm doing my placement in neurosurgery and looove it.
The day starts early at 645am when I get to the unit, drop off my stuff and look at the kardex (a summary of the key points about my patient). From that I jot down a quick to do list for the shift.
Then we cram into the report room where all the staff listen to report from the night shift over a tape recorder. They go through each patient and give us any updates. This kind of gives an idea of our patients' health status, any changes that have occurred or changes to anticipate.
After report, I try and snag a vital signs machine and go and meet my patient...usually for the first time. I take their vital signs and neuro vital signs and do my inital assessment covering cardiovascular, respiratory, digestive, urinary systems-making note of anything that seems abnormal or any changes that have occurred. I also take a look at any tubing, monitors or drains the patient has to make sure they're all running properly. My initial assessment is kind of the jump off point for my day...it tells me why my patient may be getting certain medications, it tells me if there's things I need to watch for and it alerts me to anything I may need to explore.
After I do that for each of my assigned patients, I try and grab all my medications...which usually means I'm grabbing things from 5 different drawers, while trying to compete for counter space and medication cups with 10 other nurses trying to get all the 0830 meds on the go. Meds may seem fairly straightforward... I basically look at the medication record for my patient and it tells me the medication and dose to give. But this can get tricky. If I have 10 meds for one patient and some need to be crushed, some are liquid, some are injections, some are IV meds...it gets time consuming. And if a nurse comes in and tells me my patient is going to the ICU, or getting discharged (both of which have happened), I get sent into some kind of balancing act frenzy. It gets even more fun if I come across a med, and I don't know why my patient is getting it. I don't like giving meds if I don't know why they need it, hopefully for obvious reasons. This leads me on a potential wild goose chase to find the answer, but once I do, I feel so much better.
So if I by some cosmic luck, get out of the med room on time, I usually try and get my first bit of charting done, recording my initial assessment and what my patient's been doing so far this shift.
I also take time to check the charts for any lab values I might have been waiting for, and any new orders like start this med, stop this med, start this IV, stop this IV etc etc. Now this is in no way to show that nurses are subservient wanna-be drs who do what we're told. We need physicians and they need us. We work together. If we see an order we don't understand, we have the responsibility to question it and clarify it.
I might do one bath if I have time or make some beds, but I usually don't have time for this until after morning break (which I'm lucky to get sometimes). The rest of my day usually consists of baths, oral care (nurses are also dentists don't ya know), beds, and continuous monitoring and charting, until 2pm when I write my final notes, and pack up my things for the day. This is assuming there have been no major changes and everything is going according to plan. Let me tell you it never does.
Everything might be going fine and dandy (and by that point you should be expecting something to pop up) and then all of a sudden your patient might need to be transferred immediately to the ICU. You're in the middle of getting meds for your one patient who might take a while to get them down and now you have to decide what meds to give to your other patient before he leaves in 15 min. They tell you they're moving your patient into the hallway, they need a new IV site, you need to hang this solution, the family is coming, you have to give report to the nurses in ICU, you're scrambling to get charting done. 10 minutes. That's all you get.
You have to be quick on your feet, you have to respond to situations, you have to focus, you have to think critically, and possibly most importantly you have to listen with your eyes and ears. There's so much that is told through unsaid words. And with a lot of the patients on our units all you have is what's unsaid. What's written on their faces. Sometimes you have to rely on that gut feeling, that nagging suspicion that something isn't right, or that you need to check something. Nurses intuition.
Even with all the unexpected twists and turns, the crap, the blood and the vomit, I love nursing. Eat, sleep, breathe it.

Things I've learned

For some reason this past while, I've been thinking a lot about how I've changed since I've moved out, 2.5 years ago...one year being married. I've also learned lots of quirks about Gordon...as can be expected when you get married to someone...plus our house is so small we have to work hard to not be within five feet of each other. But that's what makes life more interesting right?
10 Things I've learned about me and other things..
1. I actually don't mind most vegetables if I make them for myself (onions will always make me puke though)
2. I'm can cook a decent meal
3. I can avoid the freshman 15
4. I hate my hair being pulled (you'd think I know this before, but Gordon always seems to have some uncanny ability to pull it)
5. I can make my savings last for a long time
6. Nobody can make me laugh quite like my mum and sisters
7. I hate ironing...I can never get all the wrinkles out
8. I thoroughly enjoy a quiet house
9. I love going to bed early
10. Strawberries and cereal make the best bedtime snack

10 things I've learned about Gordon
1. He hates having sticky hands
2. Wikipedia is responsible for 80% of his knowledge
3. He has to have the bedroom door closed ALL the way
4. He has this weird thing where his feet get really warm out of nowhere
5. He's actually quite competitive
6. Bees really freak him out
7. He's incredibly ticklish
8. He's very picky about the clothes he buys
9. He's quick to pick up languages
10. He's really picky about his toothpaste (he is a dentist's son...)

365 days of marriage

First off let me apologize for the blogging hiatus. School has been taking up every last minute of my time, including eating and sleeping. It's to the point where I feel guilty if I'm not reading one of my textbooks while eating...but this is a pretty important day not to blog about.
If you haven't guessed from the title, it's Gordon and I's one year anniversary today. We celebrated it in a small way by having a nice dinner at Olive Garden, going to putt n' glo at west ed, where Gordon did beat me by two strokes, a stroll through the pet store and watching the Flames game. This morning I woke up to a paper rose and a homemade card which i thought was pretty cute, especially when I imagined Gordon making it. I made Gordon a slideshow of our year, an electronic scrapbook if you will, so we wouldn't forget the special...and not-so special things that happened to us this year. We had crepes for breakfast, and after church I was surprised with a bouquet of daisies (my favourite flower for those who don't know), which was dropped off by my sister-in-law before we got home from church. We've been enjoying reminiscing about this day one year ago and how special it was for us, the best part being that we were sealed in the temple. No matter how many other thrills and frills our wedding day had, nothing can beat knowing that you get to be with your best friend forever. I mean seriously, who doesn't want that? Everyone said the first year was going to be the hardest. If that's true I've got smooth sailing for the rest of eternity (but now I just jinxed it...). Here are some of the ups and downs of our first year of marriage

UPS: getting married!, not having to go home alone after the night is over, our honeymoon to Mazatlan, backstreet boys concert, white water rafting for the first time, hiking, spending holidays with our family, everything about our first Christmas together, surprise dates, love notes when you wake up in the morning

Downs: trying to study when someone else is distracting you, working so much you don't feel like you're married, spraining my ankle right before Mexico, getting lice from the kids I nannied and having to clean their house as well as ours, the never ending pine needles from our Christmas tree (I'm still finding them two months later!!)

Every marriage has its ups and downs. But if it weren't for the downs, the ups wouldn't be so awesome.
Here's to another amazing 365 days. Warts and all.