Saturday, December 20, 2008
bullet proof bullet points
1) There is snow. On the ground. With ice. In Seattle. It was 16 degrees Farenheight when I woke up this morning to walk the dog. We are to have more snow tonight.
2) I have been sick with a head cold all week long, meaning I am literally snotty.
3) I am working virtually all of the coming holiday week.
4) I am moving on the following holiday week.
5) Then, work again.
6) Did I mention it was snowing, I'm sick, working the holidays, and haven't packed for a move that's less than two weeks away?
Wednesday, December 03, 2008
Guinness: It's a meal in a bottle! (or, Testing a Theory)
It's a sad day in the history of my refrigerator when I realize that in order to nutritionally supplement my dinner choices, I have to crack open a can of Guinness, because I just don't have enough in my cupboard to cover a full meal.
On the other hand, I guess I could just call it for what it is: an excuse to open a can of Guinness.
On the other hand, I guess I could just call it for what it is: an excuse to open a can of Guinness.
Tuesday, December 02, 2008
Early Christmas Gift (Or *Really* Early April Fool's Day Joke)
Because I value things like the ability to keep my job--and sometimes, and probably to a much lesser degree, my self respect--I've been deliberately keeping certain things on the DL around here on the old blogger.
Happily for me (and you, dear blog faithful blog reader, who has probably wondering what obscure little cubbyhole I've walled myself in this time) I can now reveal at least one of the "somethings" about which I've been prudent enough to keep my public yap-trap (eg blog) shut.
Really. I promise I've only been holding out on you guys because, well, I needed a couple of days to actually come to grips with my own decision, and you know, it's not like my boss even knows I have a blog, but it's kind of lame to tell The Internet At Large you've accepted a job when your boss doesn't even know it.
But, seriously. I've been fairly bursting at the seams to tell you about the New And Improved Job Offer for like, days, and now that I've officially accepted said offer and given notice on my current unit, I can--without compunction and with reasonably less fear of having to retract and redact the following statements at a later date--happily and freely announce that my tenure as The Unwilling Trauma Nurse is coming to an end at what feels like, but in reality really wasn't, long last.
As of next February, I'll be transferring to Trauma Center's Sister Hospital and working in Big University Hospital's Cardiothoracic Surgery ICU.
Naturally, I couldn't be happier, professionally. Or more relieved to get the hell out of trauma, which was starting to make me feel all kinds of dead inside. (You know it's time to get out of a job when you start listening to Johnny Cash's "Folsom Prison Blues" in order to stomach one more day at work, and actually begin to identify with the protagonist's plight of serving hard time.)
Pretty soon, I can all but eschew all the crap I hated about trauma: pelvic traction, halos, cranial bolts, Licox monitoring, Jones splints, multiple ex-fixes, abdominal traumas, big, messy, massive fluid resucistations.. you are dead to me now!
Likewise, I can soon kiss a blearily drunk good bye to the endless succession of patients with C-collars and on super-confusingly written orders for partial (or full, or whatever the fuck the resident actually meant, we're not sure but we'll clarify, ASAP, promise!) spine precautions. If I never have to do another full spine turn or put someone in a Miami J collar, it'll be too many times.
Having said that, let us not pretend I'm some ICU Icarus cockily sallying forth into yet another scary speciality in critical care as blithely as shooting Swan numbers (which I can't do even remotely blithely, yet, by the way).
I'm basically scared shitless to be returning to cardiac, after a year of being out-of-touch with even basic telemetry rhythms, on a unit that doesn't know what to do with a cardiac problem other than give it another fluid bolus. In fact, I feel like I've forgotten how to be a good cardiac nurse, and I'm once again afraid of looking like a class-A moron. Like, I can just hear these CTICU nurses snickering behind their backs: "This bitch claims she was a telemetry nurse for two years, and an ICU nurse at a level one trauma center for four states? What planet is she from, Planet Asystole?!"
Plus, recovering open heart patients is not the same thing as taking care of open heart stepdown patients. And I've never had to deal with heart/lung transplant patients before, so the learning curve, again is gonna be steep, and I'm gonna need to actually pay attention and get my shit together, and get all hardcore again, which just sounds fucking exhausting to me, considering this whole entire year was about me trying and essentially failing to get all hardcore about trauma.
I'm also not saying I'm completely happy to be leaving the trauma unit. As with most transitions, I'm a little more than sorry to be leaving my colleagues. Even with the clusterfuck that was adjusting to night shift, plus the move to the Big New Unit this summer, not to mention the weird social dynamic that was merging a tiny, marginalized cubby hole of a unit (surgery, which was my initial home unit) with the glamorous, bad ass hospital show case unit (trauma)--I've gotten used to all these people. I consider them my peeps. My homies. My fellow comrades-in-arms.
It's hard to know I'm leaving an established core of really fine trauma nurses, who, like me or hate me, know their jobs like the back of their hand. At least on the trauma unit, I know who'll have my back in a shitty situation, or even in a good one, and that goes a long way in feeling marginally okay on a hardcore, scary unit, especially when you're brand new, and aware of your suck-shit, subpar critical care skills.
Pretty soon, I'll just be The New One again--an unknown quantity adrift in a sea of other unknown quantities. And being The New One is hard, especially on an intensive care unit, where nurses are generally more critical of their peers and are apt to watch you like a hawk to make sure you don't fuck up and kill your patients. (I'm not saying I don't need that kind of babysitting. I'm just saying it's hard to be new when most people are gonna assume flat out you're a dangerous idiot until you prove otherwise.) It's an intimidating environment to begin with, and often, I've found, in terms of survival and job satisfaction, the social dynamic can make or break it for you on these kinds of units.
And, I feel guilty, leaving. Yeah, I know I'm replacable, and all, and I'm sure my manager could find a much more competent trauma nurse than myself. You know, one with actual, fully developed critical care skills. I just feel bad, because for the first time as a staff nurse, I actually have a decent manager who doesn't say things like, "Staffing is your problem, bitches, deal with it!" and actually gives a shit about managing her unit. And does it extremely well.
On the other hand, being "stuck" in a speciality you aren't all that stoked about isn't really all that fun, and I can't say I'd be super happy staying on indefinitely, good colleagues or not. I liken it to being stuck doing, say, Patristics, when what I really wanted to be doing was Contemporary Theology. It's like, yeah, right on, I'm working my ass off learning Jerome and Augustine when what I really want to be getting into is Hegel and Schleiermacher. It just gets lame after awhile, being stuck in the 4th and 5th century when you really want to be like, say, in the 19th or even 20th.
Likewise, it gets lame, after awhile, taking care of the Diffuse Axonal Injury Not-So-Jet Set, with the ridiculously poor prognosis and all, when what you really want to be doing is taking care of super sick heart patients. Sure, at the point your heart is so crappy you need a new one, and have to live on a heart machine until you get one, it's a pretty ridiculously poor prognosis, too--but it's one I have interest in learning about, and that pretty much makes the difference between feeling like your job has meaning for you, and feeling your job is going to eventually crush your will to live into oblivion.
But, I have to say, as scared shitless as I am to be transfering to a new unit, working with new people, in a sort-of-new speciality--I'm also more excited about this transition in some ways than I was about going into trauma. Cardiac surgery ICU is what I've been wanting to try for a year, and I'm hoping it just doesn't come back to bite me in the ass.
And, if it does, I hope I can supplicate my way back into the trauma unit, and maybe people will just think I took a super long vacation or something, and not razz me too badly for flunking out of Cardiothoracic ICU.
Happily for me (and you, dear blog faithful blog reader, who has probably wondering what obscure little cubbyhole I've walled myself in this time) I can now reveal at least one of the "somethings" about which I've been prudent enough to keep my public yap-trap (eg blog) shut.
Really. I promise I've only been holding out on you guys because, well, I needed a couple of days to actually come to grips with my own decision, and you know, it's not like my boss even knows I have a blog, but it's kind of lame to tell The Internet At Large you've accepted a job when your boss doesn't even know it.
But, seriously. I've been fairly bursting at the seams to tell you about the New And Improved Job Offer for like, days, and now that I've officially accepted said offer and given notice on my current unit, I can--without compunction and with reasonably less fear of having to retract and redact the following statements at a later date--happily and freely announce that my tenure as The Unwilling Trauma Nurse is coming to an end at what feels like, but in reality really wasn't, long last.
As of next February, I'll be transferring to Trauma Center's Sister Hospital and working in Big University Hospital's Cardiothoracic Surgery ICU.
Naturally, I couldn't be happier, professionally. Or more relieved to get the hell out of trauma, which was starting to make me feel all kinds of dead inside. (You know it's time to get out of a job when you start listening to Johnny Cash's "Folsom Prison Blues" in order to stomach one more day at work, and actually begin to identify with the protagonist's plight of serving hard time.)
Pretty soon, I can all but eschew all the crap I hated about trauma: pelvic traction, halos, cranial bolts, Licox monitoring, Jones splints, multiple ex-fixes, abdominal traumas, big, messy, massive fluid resucistations.. you are dead to me now!
Likewise, I can soon kiss a blearily drunk good bye to the endless succession of patients with C-collars and on super-confusingly written orders for partial (or full, or whatever the fuck the resident actually meant, we're not sure but we'll clarify, ASAP, promise!) spine precautions. If I never have to do another full spine turn or put someone in a Miami J collar, it'll be too many times.
Having said that, let us not pretend I'm some ICU Icarus cockily sallying forth into yet another scary speciality in critical care as blithely as shooting Swan numbers (which I can't do even remotely blithely, yet, by the way).
I'm basically scared shitless to be returning to cardiac, after a year of being out-of-touch with even basic telemetry rhythms, on a unit that doesn't know what to do with a cardiac problem other than give it another fluid bolus. In fact, I feel like I've forgotten how to be a good cardiac nurse, and I'm once again afraid of looking like a class-A moron. Like, I can just hear these CTICU nurses snickering behind their backs: "This bitch claims she was a telemetry nurse for two years, and an ICU nurse at a level one trauma center for four states? What planet is she from, Planet Asystole?!"
Plus, recovering open heart patients is not the same thing as taking care of open heart stepdown patients. And I've never had to deal with heart/lung transplant patients before, so the learning curve, again is gonna be steep, and I'm gonna need to actually pay attention and get my shit together, and get all hardcore again, which just sounds fucking exhausting to me, considering this whole entire year was about me trying and essentially failing to get all hardcore about trauma.
I'm also not saying I'm completely happy to be leaving the trauma unit. As with most transitions, I'm a little more than sorry to be leaving my colleagues. Even with the clusterfuck that was adjusting to night shift, plus the move to the Big New Unit this summer, not to mention the weird social dynamic that was merging a tiny, marginalized cubby hole of a unit (surgery, which was my initial home unit) with the glamorous, bad ass hospital show case unit (trauma)--I've gotten used to all these people. I consider them my peeps. My homies. My fellow comrades-in-arms.
It's hard to know I'm leaving an established core of really fine trauma nurses, who, like me or hate me, know their jobs like the back of their hand. At least on the trauma unit, I know who'll have my back in a shitty situation, or even in a good one, and that goes a long way in feeling marginally okay on a hardcore, scary unit, especially when you're brand new, and aware of your suck-shit, subpar critical care skills.
Pretty soon, I'll just be The New One again--an unknown quantity adrift in a sea of other unknown quantities. And being The New One is hard, especially on an intensive care unit, where nurses are generally more critical of their peers and are apt to watch you like a hawk to make sure you don't fuck up and kill your patients. (I'm not saying I don't need that kind of babysitting. I'm just saying it's hard to be new when most people are gonna assume flat out you're a dangerous idiot until you prove otherwise.) It's an intimidating environment to begin with, and often, I've found, in terms of survival and job satisfaction, the social dynamic can make or break it for you on these kinds of units.
And, I feel guilty, leaving. Yeah, I know I'm replacable, and all, and I'm sure my manager could find a much more competent trauma nurse than myself. You know, one with actual, fully developed critical care skills. I just feel bad, because for the first time as a staff nurse, I actually have a decent manager who doesn't say things like, "Staffing is your problem, bitches, deal with it!" and actually gives a shit about managing her unit. And does it extremely well.
On the other hand, being "stuck" in a speciality you aren't all that stoked about isn't really all that fun, and I can't say I'd be super happy staying on indefinitely, good colleagues or not. I liken it to being stuck doing, say, Patristics, when what I really wanted to be doing was Contemporary Theology. It's like, yeah, right on, I'm working my ass off learning Jerome and Augustine when what I really want to be getting into is Hegel and Schleiermacher. It just gets lame after awhile, being stuck in the 4th and 5th century when you really want to be like, say, in the 19th or even 20th.
Likewise, it gets lame, after awhile, taking care of the Diffuse Axonal Injury Not-So-Jet Set, with the ridiculously poor prognosis and all, when what you really want to be doing is taking care of super sick heart patients. Sure, at the point your heart is so crappy you need a new one, and have to live on a heart machine until you get one, it's a pretty ridiculously poor prognosis, too--but it's one I have interest in learning about, and that pretty much makes the difference between feeling like your job has meaning for you, and feeling your job is going to eventually crush your will to live into oblivion.
But, I have to say, as scared shitless as I am to be transfering to a new unit, working with new people, in a sort-of-new speciality--I'm also more excited about this transition in some ways than I was about going into trauma. Cardiac surgery ICU is what I've been wanting to try for a year, and I'm hoping it just doesn't come back to bite me in the ass.
And, if it does, I hope I can supplicate my way back into the trauma unit, and maybe people will just think I took a super long vacation or something, and not razz me too badly for flunking out of Cardiothoracic ICU.
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