it burns!

So I made it through my first orientation Nite Shift (like Nick at Nite! not really.) I had a nice preceptor who reminded me of my first nursing school clinical instructor, and we got along great. She sensed I was a Hard Worker and Not Overly Stupid, and I sensed she was a Really Good Nurse, one of those nurses that makes nursing look so effortless and easy. (I'm not one of those nurses; my job makes me feel like I'm about five different people doing twenty nine different jobs at once. It does not feel easy or effortless, and most of the time I look like one of those crazy street people with which you try to avoid having any involvement of your own personal space).

It all worked out, even though I was pretending for half the shift not to be hyperventilating/tachycardiac and just as in need of a Cardizem drip as some of the patients, and the other half hoping I didn't look like I should rate a Glasgow coma scale of 7. Due to the fatigue, you see, and how 10 p.m. is my new bedtime, and yet I was up all night feeding old crazy people ice chips and fishing around in liquid poop for "occult blood" which sounds scary and devil-worshipping, but isn't that glamorous by far, I promise.

It was actually one of the best nights I could have ever imagined: only four patients plus a facility transfer admission at 4 a.m. (of the chest pain/nitro drip/pending cath variety--WITHOUT ORDERS, which we all love, because then we get to call the sleep deprived attending on call at 4:30 a.m. so he can curse the gods and wail and gnash his teeth poetically).

At nine p.m. last night, I said to my preceptor, "Uh, it isn't typically like this on your floor, is it? Because, uh, this is great."

"Oh, no" she replied breezily, "You should have seen me the night I oriented David, the other traveler. It's a good thing he was like you, and didn't need any hand-holding, because we got slammed that night--it was nuts."

Yeah, that's what I was afraid you'd say, I thought to myself, but still happy our luck seemed to be holding out and census remained low.

Also, the next time I take report on a facility transfer at ten to four in the morning, I'm gonna make sure the patient has admitting orders, because if I ever think I'm in a land where professional courtesy means something--yes, I'm ragging on lazy ass nurses for a change-- I'd better get a STAT geriatric consult and make sure I'm not losing my mind.

I'm back to my cardiac medical patient population--crazy elderly folks with all kinds of things wrong with them, the biggest of which seems to be society has no idea what to do with their problems and hasn't a clue how to allocate the proper resources to facilitate their care and well-being.

On the one hand, yey, the biggest thing I have to worry about is getting a restraining order and/or flash pulmonary edema. On the other hand, yuck, restraining orders/flash pulmonary edeam.

At least they were cute, and not mean, which is an unfortunate but frequent consequence of dementia. One little man kept saying, "I walked without a walker yesterday! Is it morning? I walked without a walker yesterday! What time is it?" and another guy kept saying, "Can I have more ice chips? I can't hear you. Huh? Hey, what about my ice chips?! Don't forget my ice chips!" He was big on ice chips, if you couldn't tell.

Two of my patients had fake eyeballs, which are really freaky when the patients sleep, because they look dead at first glance. Dead is, generally speaking, Not Something You Want to Have Happen Unexpectedly in a Hospital Setting.)

I'm back again tonight, and not at all thrilled at the q4h charting thing, or the stupid IV pumps this facility uses (what do you mean, I have to calculate my own nitro drip rates and convert mcgs/kg/whatever time unit to mgs/hr! I can't even remember my own social security number at 4:30 in the morning, let alone drip factor conversions! Where's my Colleague Guardian Baxter pump?!)

But, the floor is nice, the nurses seem nice and not like they want to kill me for being an outsider, and well, there's always Ice Chip Guy to make me realize my life could be a lot suckier than it is already.