Nursing Voices

Thursday, April 12, 2007

Hasta Luego

To all my faithful readers... I can't imagine there are many of you left out there.

Just a quick hello and "see you later" (not exactly goodbye).

Blogging is just not happening in the midst of my busy life right now, and I'm "giving up" on it for now.

I appreciate all the thoughts, feedback, and smiles you've provided. I hope to check in on your blogs when I get a chance... you've always been a source of inspiration and encouragement.

So, for now, hasta luego!

Tuesday, March 27, 2007

Still Here.

If there has been a lack of writing as of late, it hasn't been for lack of things to say, just the time in which to put the words to "paper" (or screen, as it were).

Status: MIA

Hope to be back in full force soon.

Friday, March 16, 2007

Watch that First Night. It's a Big One.

Spring fever. Gone.

Winter. Back.

I feel like hibernating all over again.


My mind is a bit fuzzy... sleep deprivation will do that to you.

Working nights is hard on the body, but there's no doubt that the first night back is the hardest. I know some who nap before coming in that first night, but my body just won't do it. I try to sleep in for a couple of hours the morning before because that seems to help a bit, but there's nothing quite like being up all day and then expected to function on a highly-skilled nursing level all night as well. To those patients who are sad to see me go, anxious that the next nurse will be a different personality, I am quick to point out, "I am a waste of space after 7:00am... you really wouldn't want me here!" My brain clocks out before my hands can fumble through the motion of swiping my tag.

A few night-shift survival mechanisms that have helped me to make it through:

1. Sleep when you can on your days off... your body will thank you! Sometimes it's hard to switch back and get to bed at a reasonable hour when you're coming off a string of nights, but it makes a difference in the long run.

2. Get regular exercise on your days off... being in good shape is a huge boost, your energy level will be higher all the time.

3. Bring something to munch on in the car on the way home. That drive can be a killer. Literally. For some reason, having something in my mouth keeps my eyelids open.

4. Don't rely too much on caffeine. I've done it both ways, and my body seems to regulate between sleep and awake much more efficiently without. Can't seem to give up that one last cup of coffee... but I've lived on as many as 8-10 cups a day. Say it with me, "Mod-er-a-tion."

5. It's ok to use a sleep aid once in a while, and for some of us, a little Tylenol PM or Benadryl will do the trick. If you're an Ambien advocate, so be it. Just try not to get hooked! And be aware that you may feel a little groggy when waking. It's never been bad for me, and sometimes what I really need is the good, solid (vs. restless, dream-filled) sleep provided with a little medicinal assistance.

6. I'm all about the old-fashioned ear plugs and room-darkening shades. Some people can't stand the feeling of the plugs in their ears, but with boisterous children in the house, I find they're invaluable. And a dark room is awesome, almost tricks your body into believing it IS night-time (key word, almost).

7. Give it time. Eventually you'll get used to those bags under your eyes, and the dull throbbing at the base of your skull. People will stop asking if you're ok, because now it's just the way you look. It's alright... you're a night-shifter... and night people RULE!

Or at least we like to think so, in our delirious, sleeping-while-sitting-up state.


Tuesday, March 13, 2007

Sunshine, Happy

Does anyone else have spring fever so bad it hurts?

Despite the fact that we have snow predicted for Thursday, today is a beautiful tease, a happy reminder that inevitably the snow WILL melt, the juncos will scatter to the north, and the robins will return.
Thank goodness for sunshine!
It's an odd world that we inhabit as hospital nurses, particularly on night shift.
Surrounded by concrete walls, ensconced in darkness, our shifts are marked by activity and change, nonetheless. We take vitals, listen to lung sounds, page doctors, deliver babies, regardless of the outside world and irrespective of the late hour.
Usually, we have a vague sense of what's happening outside as the few patients and doctors come and go, remarking upon significant events or weather phenomena. But there are also times when we walk through the hospital doors at the end of a shift, only to find a dense fog, a new layer of snow, a howling wind. The quiet corridors and dim rooms don't always belie these changes, as they have no bearing on what happens within.
Just a thought, as I sit here and soak up the luscious new warmth. My friends who are working today have no sense of this bright sky, this gentle breeze. How strange to think that if I were there, or were sleeping between shifts today, I, too, would have missed out on this brief glimpse of spring coming.
Thank goodness for the reprieve of a few days off!

Saturday, March 10, 2007

Spring Forward!

To those of you day-shifters that are grumbling about the shortened night tonight, all I have to say is,

"Hoo Hoo Hahahahahaha!"

(Smug grin.)

We earned it.

See you bright and early tomorrow morning!

Friday, March 09, 2007

Driving to Work in the Dark

Snow drifts on the ground.

My breath hangs uncertainly in the frigid air.

Winter still. Stubborn.

But as I drove to work in the warm cocoon of my car, I was transformed by a vision of bright rows of lights, shining festively through the transparent walls of a greenhouse at one of the nurseries I pass by.

Instantly invigorated!

I imagine the vibrant lights perched above tiny seedlings, coaxing them to grow despite the lingering reality of winter outside their sheltered walls.

And as the birdsongs further testify this morning, spring is coming.

They know it.

And I am hopeful again.


I enjoy working at a teaching hospital. Really.


It can be extremely, astoundingly, incomprehensibly frustrating when the team of residents on call are a bunch of indecisive know-it-alls. Sounds contradictory, right? Maybe that's why the plan of care for my clinic patient (whose care is overseen by the residents) changed every 5 minutes or so last night. They all know it ALL and are ALL making the decision.

Draw labs at 0500.

(talk to senior resident)

Cancel that, let's recheck them stat.

Straight cath her.

(discuss with attending)

Actually, now that you just cath'd her, I think we're gonna need a foley.

Let's hold off on the Mag.

(enter senior resident)

Pressure's up but we'll just keep a close eye on it. And better draw those labs again.

(update chief again)

Now we are starting Mag. And antibiotics.

And some rectal Tylenol.

And I think she's gonna need a section.

(review with attending)

Yeah, let's just do the C-section now.

Hold that thought, the other clinic patient needs a section, too. This one can wait an hour.

*** hour goes by while I furiously try to catch up with meds and charting and explain to family why, despite the fact that the decision has been made, we can't do the C-section right now***

(re-enter senior resident)

Let's go, we're ready NOW!

Intersperse numerous cervical exams by whichever resident is around at the time, and you may have a potential cause for the chorio.


Baby did great, and the patient came through it all okay.

The nurse, on the other hand, feels defeated and sad. For the patient, for herself, and for a system that could clearly be better.

Thursday, March 08, 2007

Once again, Change of Shift is up at Emergiblog...

I'm headed over there for some gread reads!

Maybe one of these days I'll come up with something worth submitting.