Nursing Voices

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.

The 50-Yard Dash

Gearing up for another weekend.

Thinking, "I must be a sprinter."

Life is cyclical, and everything in my life seems to rotate through short bursts of activity.

This week, working out.

Last week, housecleaning.

Before that, writing.


Keeping in touch with friends.



Some weeks (a lot of them during these dark winter months), I can't seem to accomplish or keep up with any of it.

I don't have the stamina to sustain any one of my endeavors consistently in the long run. I am not a long-distance runner. I don't know how some people do it.

They must drink a lot more coffee than I do.

I know what my constant is: procrastination. I'm an expert, and that one never fails me.

We all have our talents, right?

Tuesday, March 06, 2007

Burning, Burning

Here I am, after taking some of my fellow bloggers' fabulous advice, straight off the treadmill, riding high on workout endorphins (and not a little lactic acid!)... burn out? Me??? Never!

Well, okay. I'm trying.

This nursing thing is a roller coaster. A lot like life in general. Good days, bad days. I try not to carry too much of it with me, but apparently am not completely successful in this endeavor. The work dreams are not a rarity. They happen almost every weekend, and occasionally during the week. I'm hoping they're just my mind's way of decompressing.

On the one hand, nursing is a great career. Talk about job stability. They're practically beating down our doors to offer jobs to qualified nurses! I'll always have multiple avenues of practice available if I become unsatisfied with the work that I do now. And I still look forward to most of my shifts, have a sense of camaraderie with my coworkers, enjoy the way my schedule works with my life (most of the time), and am forever in awe of the breathtaking moments my job allows me to witness.

But there are other moments, too. Anyone who has read my blog before can attest to the heavy amount of skepticism I hold for the hospital establishment and the system in general. Paperwork and charting are significantly overvalued in a legalistic atmosphere that reeks of the fear of liability and malpractice. Night shift is great, but my body does not always agree... I've become accustomed to a certain amount of fatigue and fuzziness that never really goes away. And on... and on...

So what, you say?

Nothin' really... these were just a few of my thoughts while burning calories and trying not to burn out.

Thursday, March 01, 2007

Working Hard, Even When You're Not There

Vivid dreams of a terrible shift... working, working. So busy, patients everywhere, bad heart tones in every room. I must have been in charge... I found myself running from one room to the next, putting out fires, starting IV's, calling docs. Remember struggling for a while with IV lines that were hopelessly tangled, and not compatible with our pumps, so I must have dug up an ancient pump from somewhere and figured out how to get the IV running and attached to a pole. Ran to another room to help with an IV, and a newer nurse was poking her with a 20 gauge... thinking, "What are you doing?! We need an 18 gauge!"

In the midst of it all, my kids were there with me, except it was my friend's kids, but they were mine, and the baby was so small, and I had to hold him while he slept. It really pulled at my heartstrings as the chaos swarmed around us.

So strange.

And I haven't even worked my first night this week.