Hello, it’s me

Hey guys…!

…It has been a year and half since my last post…

I know, I’m terrible at this. I actually forgot I still had a blog. Until my boyfriend told me that for my “new years resolution”, I should write in my blog again. It’s already the end of January, but hey, I’m here. I really do enjoy writing, I swear! I feel that I can articulate myself much better through writing than I can verbally, or on the spot. I was just reading my previous posts and realized how much I miss ranting and rambling to the world (…OK maybe likely definitely just the one or two people who actually read my posts…including me…).

I’m currently wondering how I can possibly get my readers up to date since the last time I wrote, which was…July 2015. Geez. Babies born then are walking and talking now. Anyway, the first thing I did when I dug out my blog from its cyberspace grave is update the “About Me”. Because, ladies and gentlemen, I’m a whole new person! …just kidding… not much has changed and life has been pretty much the same (+/- a few things as life goes) as it was a year and a half ago. Well, besides the obvious fact that I can no longer self-identify as a new nurse. I think photos also need to be changed once in a while, but people might realize how crazily I have aged after being a bedside nurse for 2 years. Ha…ha…

Anywho. Quick catch up with my personal life. I’m putting my mind on rewind, back to 2 summers ago (I can practically hear the whirr). Besides working almost full-time hours that a casual nurse does not normally do, I have been to Ottawa and back to Toronto countless weekends, gone on several amazing backcountry camping trips in Algonquin Provincial Park, went to Germany and Spain over the Christmas holidays, made the newbie mistake of most first-timers to Europe and travelled to WAYYYYY too many countries over a span of 3 weeks in the company of my best friend, and witnessed many sunsets more beautiful than the last. Oh! I also moved out of my parents’ house and into a one-bedroom apartment downtown! Yay! I am now a sucker for new housewares and sales at the grocery store. …But damn that rent…and those hydro bills…

In terms of catching you all up with my professional/work life, work has been quite blah recently. The patients being admitted to the unit are heavier than it has ever been (and even senior nurses are saying this!), so shifts have been incredibly stressful the last few months (but that’s nothing new). Won’t go into details here and now but thank goodness for being able to leave work at work.  Anyway, so far into my career I have completed one post-grad Coronary Care 1 course and had a pre-grad nursing student under my wing for a couple of months. Which just means she followed my work schedule and I have to try to teach all that I know in the few short months she is training on the unit. She passed with flying colours and nobody died so that’s a good sign, right?!

I really do wish I could have written more about each personal and professional experience in more detail, but those times have passed and there will always be more exciting things to come. I do know that I won’t be working on the General Medicine unit forever, so I will definitely try to update my blog whenever that happens (months or years from now, who knows). I plan to take another course with Humber College and get my Advanced Cardiac Life Support (ACLS) course done sometime this year, so hopefully that works out (writing that here is actually really good motivation to get it done)!  I also have a sweet vacation coming up soon where I’ll be gone for almost a month! Hint: the mountains were calling. Maybe I’ll write about it next time 😉

Full disclosure: I don’t know if this is a comeback post, or a goodbye forever post, or a hey-guys-it’s-been-another-year-since-I-last-posted kind of situation, but hey, life is busy when you’re paying the bills and everything in between! 😉

Cheers!

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Finding a Balance

Hello strangers! Okay… I’m sorry…I know I have been slacking on my blog for too long.

I always tell myself that I will write on my blog on my day(s) off, but when time comes, I have already made plans, have “no time”, or honestly… just feel too lazy to write.  Anyway.  I finally decided to have a “do nothing” day off because I feel like I am constantly on the go, for both work and play, and have finally realized that I need some time to actually relax, and make time for myself.

So much has happened since the last time I wrote (…back in May…oops), when I had just gotten off orientation.  I have already had a few nursing students work with me, which was really weird for me at first because I was so used to being the newbie.  Instead, I was the one teaching and answering questions.  The timidness and self-consciousness of nursing students was a feeling I could relate to all too well, and not so long ago.  I had my first Code Blue (medical emergency/unresponsive patient) on the unit a few weeks ago, and the nursing student working with me that day commented that I/all the nurses remained so calm throughout the emergency, that even she felt calm.  I remember the first time I witnessed and participated in a resuscitation in the Emergency Department as a nursing student, and I was so shocked at the end of it all, I started bawling uncontrollably.  I know I’ve mentioned it before, but it’s funny how you don’t notice how much you’ve changed, or grown, until you look back a few months later.  I guess because I have really just begun my career, the changes are most noticeable now.

The biggest challenge I mentioned in my previous posts was Time Management. Although it continues to be one of the biggest challenges, I have come to realize that it is not something I can have control over, because of the nature of the unit and the acuity/unpredictability of the patients. Anything can happen at any time, and that’s just something that needs to be accepted as part of the job.

Now that I am acutely more conscious of my role on the unit, I am beginning to realize that the biggest challenge for me truly is putting myself first/before my patients, or anyone else.

In a profession where caring for others is the driving principle of most, if not all, of your work, it can be difficult to think about yourself.  For one, the Care Delivery Model on the hospital unit is Total Patient Care, which is when one nurse/caregiver carries out all care responsibilities for the patient(s) under her/his care within her/his scope of practice.  This includes a range of interventions and skills, such as personal hygiene, health assessment, medication administration, care and maintenance of foreign tubes and catheters, wound care, and patient/family education.  When there are so many things to do for each patient, with a nurse to patient ratio of 1:5 or 1:6 every shift, it gets busy – to say the least.  Sometimes I don’t even have time to think about taking a drink of water or going to the bathroom.  I would find myself having a sudden, strong desire to pee while emptying a patient’s Foley, or suddenly realize how dry my mouth is while carrying medications and large cups of water into a patient’s room. Or the sudden realization that my patients have already had all three meals for the day, when the last time I ate was in the morning.

I know about Burnout. Stress. Compassion fatigue.  I’m a huge hypocrite when it comes to this matter – I give the same advice that others are constantly giving me.  “You have to go for your break“, “give yourself a few minutes to relax“, “take some time to sit and have a bite, and then get back out there“.  But somehow, it doesn’t register in my mind in the midst of all the chaos.  All I can think about is, I need to get this and this and this and this and this and this done by the end of shift.  It’s difficult to think about yourself when your patients are not doing so well.  Patients can deteriorate quickly.  Doctors enter orders in the middle of the day, sometimes close to the end of shift.  Patients are discharged and new patients are admitted to the unit at all sorts of different times.  You have to document everything on everybody.  And do everything else in between.  I often run around like I have my head chopped off, so time is not a concept I can easily grasp when there is so much going on and so much that needs to be done.  I tell myself this time and time again, especially when I do have a bit of a…er… nervous breakdown. 😦

It is a given that there have been (and there always will be) plenty of awful days at work that I just can’t stop ranting about to my boyfriend, friends, and family (usually something that has to do with the heavy workload) – fortunately there are also the days, or moments, that make up for the ones I never want to relive again. 🙂  Yes, the stress gets to me pretty easily, and yes, I want to rip out my hair one strand at a time some days.  When it all comes down to it, sure, it is “just” a job, which is how many people see their work; however, finding purpose and meaning behind such sensitive work is what gives me the most motivation and energy everyday when I walk into the hospital.  When a patient’s family member tells you that another patient told them that you were “the best nurse they have ever had”, it gives you the most incomparable feeling of consciousness and satisfaction, that you are being recognized for doing something right.  However, I am beginning to see that even with the most pleasant of moments, I remain very vulnerable to the consequences of burnout, and know that I still need to find that balance between caring for others and caring for myself.

Most of my life has been spent trying to shrink myself. Trying to become smaller. Quieter. Less sensitive. Less opinionated. Less needy. Less me. Because I didn’t want to be a burden. I didn’t want to be too much or push people away. I wanted people to like me. I wanted to be cared for and valued. I wanted to be wanted. So for years, I sacrificed myself for the sake of making other people happy. And for years, I suffered. But I’m tired of suffering, and I’m done shrinking. It’s not my job to change who I am in order to become someone else’s idea of a worthwhile human being. I am worthwhile. Not because other people think I am, but because I exist, and therefore I matter. My thoughts matter. My feelings matter. My voice matters. And with or without anyone’s permission or approval, I will continue to be who I am and speak my truth. Even if it makes people angry. Even if it makes them uncomfortable. Even if they choose to leave. I refuse to shrink. I choose to take up space. I choose to honour my feelings. I choose to give myself permission to get my needs met. I choose to make self-care a priority. I choose me.
―D.K.

A Sense of Freedom

I feel as though so much has happened since my last blog post – it’s been almost a month.

Big news: I am finally off orientation! I met with my educator last week Thursday morning after my last official shift on orientation, to discuss my progress. We went through this long check-list of stuff that I need to know as a new employee on the unit, including unit routines and practices, documentation, medication administration, clinical practice, and the types of patients that are commonly cared for on the unit (i.e. neurological problems, cardiac problems, respiratory problems, nephrology problems, cancer). I was honestly so surprised by how much I had seen and done in my orientation period.

I have been busy working full-time hours in my casual position at the hospital, and just started taking on my own patient load this past Saturday. It’s actually a bit terrifying now that I am on my own and expected to carry the typical 5-patient load on days, and 6 or 7 patients on nights on the medicine unit. Fortunately, the orientation period was pretty amazing, and I am incredibly thankful for it. Some of my peers from nursing school only had 2 weeks of training on the job before they were released into the wild…I mean, working on their own. I think an intensive training period is especially important for someone’s first job in almost any career; on-the-job learning is the best way to learn (IMO) because school can only teach so much, which is generally the basic foundations and knowledge – not, for example, the policies and procedures of a hospital that guide many of the nurses’ actions, which can vary widely between organizations, agencies, and institutions. Nursing generally involves the safety of vulnerable populations, so a thorough training period is critical. I had 2.5-3 months of full-time training with a preceptor, without the Nursing Graduate Guarantee Initiative program (support/funding from the Canadian government for full-time work opportunities, for new graduate nurses), so I would definitely consider myself one of the lucky ones.

My biggest challenge this far has been Time Management. Honestly, managing time can be nearly impossible sometimes, especially with the unpredictability of the unit. Fortunately, my colleagues and educator have been very supportive and good with checking in on me regularly to make sure I’m okay, and give me tips and the necessary resources for the things I need to work on. It is all especially appreciated as a new nurse. I have already had three shifts on my own, and although stressful (as expected), so far so good! I’m excited to have reached this milestone, especially because I remember feeling like an alien when I first started – new environment, new people, so much to learn – I honestly felt like I had forgotten everything I had learned in school.

It’s amazing that I barely notice any changes day-by-day, but can look back 2.5 months to my very first day, and say to myself, “wow, that’s a huge difference from me then and me now.” Everyday is a new learning experience – and the learning never ends – so I can only hope for the best, for the foreseeable challenges in the upcoming days, weeks, and months.

Cheers! 🙂

Patient Moments: The Lady in Pink (Sunglasses)

I was in a patient’s room priming some IV tubing, when I heard the ward clerk page me overhead. I squeezed the patient’s call bell at the bedside to indicate where I was. The nurse told me I had a new admission to the unit, and that she was already in her room.

It had been a busy day and I was tired and hungry. I had not gotten my lunch break yet, and my stomach growled to remind me of its neglect. I hoped the new patient was mostly independent. I quickly glanced at her age in the chart. 88 years old. Oh boy. I hurried into the room to see my patient.

She was lying in the hospital bed, almost in a sitting position with the head of her bed elevated, and she looked up at me in her large bubblegum pink tinted sunglasses, which took up nearly half of her petite face. I smiled and greeted her, “Good afternoon, Mrs. X!” I introduced myself as her nurse for the day. She smiled back with a huge grin, bright pink lipstick splashed on her lips and some noticeably on her teeth. I took her vital signs (blood pressure, heart rate, oxygen saturation, temperature, respiratory rate), asked about her pain, listened to her breathing, and asked her the usual questions for new admissions to the floor – questions like, “How do you feel right now? What’s your pain like now? Any dizziness? Any history of falling? Do you wear dentures? Are you normally able to walk around? Do you use any assistive devices at home?”, and she answered them all with confidence. I scribbled down her answers mentally. She was hard of hearing from one ear, and near-sighted, but she was still able to read and write just fine. She had The Help by Kathryn Stockett and a half-filled newspaper crossword at her bedside. She was very bubbly and talkative. I oriented her to the room, ensuring her personal items were within reach and then gave her the call bell. “Press this if you need anything! I’m going on my lunch now – N will be covering for me so she will come if you need something from her.”
“LUNCH?” She squawked. “It’s almost time for supper. Thanks dear. I’m fine, hurry and get some food for yourself. I’m going to do my eyebrows now.” She flashed another lipstick-stained grin and fished out a pair of tweezers from her cosmetics bag. I couldn’t help my grin as I left her room.

I remember one of our earlier conversations, her second day on the unit. We were having a conversation for approximately 10 minutes, and I was standing by the foot of her bed.

“You remind me so much of that nice nurse I had last time, oh, what was her name?”
“Hmm, I don’t know. Was it Laila? Your night nurse?”
“No. It wasn’t Laila.”
“Sandra? The one in the purple scrubs? She was in here with me earlier today.”
“Nooooo. Her name was much longer.”
“I don’t know who it could be. You just got admitted to this floor yesterday and it has only been the three of us who have been caring for you. Maybe it was another nurse who was covering for one of us.”
“Come here.” *The patient peers closely at my ID badge*
“STEPHANIE! IT’S YOU!”

She was my patient for the next three days. Everyday, she was bubbly and pleasant. She had family members coming in to visit all the time, including her sons and many grandchildren. Every time I entered her room, I always left smiling or laughing. Her mood was contagious (fortunately, her diagnosis was not 🙂 ). We talked about books, the past, the future, her kids and her grand-kids, her life at home. I enjoyed having conversations with her whenever I could, and they really made my day.

The following week, I had a completely different patient assignment, and Mrs. X was still an inpatient on the floor. I had to run into her room at some point during the day to grab the commode for another patient, and stopped to say hello. The patient shrieked and said she had been waiting for me. I told her I was not her nurse that day, but took a moment to ask how she was doing.
“Oh, I am so happy to see you. Come give me a hug.” I laughed and we hugged awkwardly with her in her usual sitting position in bed. It was probably more like a pat on the back, but it was sweet.

I had a busy shift that day, and went for a late lunch break at 5PM. When I returned, the nurses told me that Mrs. X, in her large pink sunglasses, had wheeled her walker over to the nursing station three times to ask for me, to say goodbye, since she was being transferred to another facility the next day. This made me feel so touched. Knowing her diagnosis, and the level of pain she had been in before, with even the slightest of movement, I could only imagine how much of an effort it must have been for her to get up and walk – and just to try and catch me to say goodbye. After our farewells and good lucks, I left the hospital thinking about how much my patient interactions actually influence my love for working as a nurse.

Honestly, as a new, inexperienced nurse, I feel like I am constantly searching for some kind of confirmation that I am doing my job right. Knowing that I actually did make a difference in my patient’s hospital stay, as expressed to me by a patient him/herself, is the type of nursing care I hope to provide for all of my patients.

Patient Moments

One of my favourite things about nursing has always been the nurse-patient relationship. My shifts are always 12-hours at the hospital, and in that time, a lot can happen. Establishing trust, building rapport, getting to know your patients – that makes up a significant part of my day, whether it be in addressing their physical, emotional, psychological, and/or spiritual needs.

I will be introducing something new to my blog, called Patient Moments. Once in a while, hopefully regularly, I will post a favourite or memorable moment with a patient. 🙂

In the upcoming series, I will write about patients who remind me that nursing is indeed the right profession for me. It can be extremely challenging some days when it feels like nothing is going right, when time is passing by faster than it is needed, when there are a million and one things to do before the end of shift, when patients are rude, when patients are pounding their call bells every 15 minutes, when families are jumping down your throat for answers, and so on. Sometimes, a single patient, or even a single comment or conversation with a patient or family member, can change your whole day, make your crazy day ten times better. I am inspired and motivated everyday by the people I speak to, the people I listen to, the people I care for.

Of course, I will always be careful to maintain privacy and confidentiality by changing possible identifiers (names, room numbers, date of admission, etc.). The first Patient Moments post I’ll be writing will be posted within the next few days, due to work. Thanks for reading, I hope you’ll enjoy! 🙂

The Other Job

Ah, where to start? I have not been able to update my blog in a while.

I just finished a 70-hour work week and I am exhausted. After a crazy shift at the hospital, and being fully aware that I have another one ahead of me after a few hours of sleep, I find it rather difficult to feel inspired and post about my day/thoughts/experiences, when I would much rather crawl into the warmth, and bathe in the comfort of my bed for a few days. Fortunately, I always get a few days off in between the madness to recuperate, which also means time to write – yay! …Unfortunately, I can be a bit of a workaholic and sometimes choose to spend my days off work by working at the part-time job I have had at an independent movie theatre, since second year of nursing school. I know… I get a lot of, “WHY???”

I was told several times, that although I was hired on the unit as casual (on an as-needed basis), I will most likely get full-time hours once I am off orientation and on my own, simply due to the nature of the medicine unit. Honestly, I guess this part-time job I still hold is a comfort zone thing, versus to make more $$$…and I always make sure I still enjoy some time off for myself and with loved ones. The flexibility in scheduling at the theatre is phenomenal, so I don’t need to work a set number of hours per week or anything; I just work when I can or when I want to. Working at the hospital is still a very new thing for me – the job, the people, everything – and I continue to hold on a little too tightly to my old part-time job, since I know it (and my coworkers) very well, having worked there for so long. Maybe I also have a slight fear of growing up and starting my career, but my job at the theatre also represents my past life as a student trying to pay for school, make some pocket money, that sort of thing. The people I work with, I would probably never have tried to befriend or talk to otherwise, but they are all amazing people – do I really want to be surrounded by only health care professionals all the time? Additionally, because the job I have on General Medicine is very unpredictable, I believe the predictability of working at the movie theatre is actually very appealing. At least until the popcorn is burning and nearly sets off the fire alarm. Anyway, it’s a lot less stressful.

I also just really love to work with people. I’m not a huge movie buff (…as those who know me already know…) but I enjoy working at the theatre nonetheless. Everyone watches movies – you can see the people you went to high school with walk in, an old elementary school teacher you had, a family member, the elderly couple who lives next door, the family you see at the park all the time, the people who only watch movies on cheap Tuesdays – anyone can walk in through those doors to catch a flick. At the theatre, the customers you speak to aren’t (visibly) ill, or dying. You can actually spend time to have a conversation with a stranger about anything, as opposed to giving someone just enough time to watch him/her take their medications because you have to run off and help another patient (disclaimer: this is not all of what nursing entails!). The ambiance is vastly different from where I work in the hospital – it’s not so heavy, not so emotionally, mentally, or physically demanding. Of course, as it is with all people-oriented jobs, the customers and/or the people you work with aren’t always the greatest people in the world, but there are always those who can make your day with a few kind words or awesome gestures (for example, the guy who brought me and my coworker 4 beers for finding his phone in the theatre).

And I can watch free movies.

Maybe I have achieved an altered perspective on my job at the theatre now that I am finally working in the field I studied in school for, but I am not ashamed to be working what most people consider merely a job that makes near-minimum wage. And maybe it sounds like I’m asking for burnout by working both jobs, but I won’t hold on to this job forever. Simply, for now, it is a sliver of serenity in the midst of my chaos. 😉

Before the Sun Rises

The first alarm on my phone goes off at 5:30AM. The alarm clock I had intentionally placed a metre away from my bed, just beyond my reach, sounds at 5:35AM, starting off soft and steadily increasing in volume as the seconds tick by. My eyes remain closed, my mind groggy. Didn’t I just fall asleep? I can not wrap my head around the fact that it is time to get up; a 12-hour shift lies ahead. I struggle to open an eye to peer at the time. 5:38AM. Multiple alarms are going off simultaneously now. I throw the blankets off in a meager attempt to motivate my body out of bed. After a second of being blanket-less, I throw them back on. I blindly feel around my bedside table to find my now-screaming phone. Then I turn on my side and stretch as far as I can at the time, to turn the bloody alarm clock off. In the new silence, I fall back into bed and feel a calm. I stay there, curled up on my side, a few minutes longer, wavering on the edge of wakefulness and blissful sleep. My mind finally screams for me to get up. I open my eyes and wait until they adjust to the darkness. 5:43AM. I slowly crawl out of bed, my feet fumbling to find my slippers. I stand up rather unsteadily, eyes still half-closed, and force myself to move my feet, away from the warmth of my bed, and trudge over to the bathroom.

Teeth brushed, face washed, eyes now somewhat opened, straight into the hot shower. There’s just something about a shower in the mornings that finally wakes me up. Tightly wrapped in a towel, I march back into my room. 6:12AM. My goal is always to finish getting ready by 6:30AM so I have time to figure out if I need a coffee, and how I’ll get to work, which depends on the weather and how I feel. Walk – 22 minutes. Bike – 9 minutes. Streetcar – 12 minutes, or more if I have to wait longer than 3.

I put in my contacts, brush my wet hair. 6:17AM. I start to get dressed, and pick out my scrubs. My favourite set is grey and black, which was handed down to me from my mom, practically brand new. Plus, I don’t feel like a potato wearing it. I just put the scrub top on, stuffing the bottoms in my backpack to change into once I’m at work. I have to make sure I have my ID, stethoscope, hair tie, and lucky pen. I always have a ton of back-up pens in my bag, just in case – back-up pens are a necessity in the world of nursing. 6:27AM. I grab my lunch from the fridge in the kitchen downstairs, fill my 1L water bottle, and gulp down a cup of water – maybe have a banana if there’s a minute to spare. 6:31AM.

I’ve been taking my bike to work the last 3-4 weeks now, since the early stages in the transition from winter to spring. There were some pretty chilly days where I did have to give biking a second thought, but I’m just so happy to be back on my bike again, that the cold doesn’t bother me anyway. 😉  I have the best parking spot everyday – just steps from the hospital entrance. I walk past the Tim Horton’s (when I don’t need a shot of caffeine), and take the elevator up to the General Medicine unit. 6:43AM.

The night nurses are usually still bustling about the unit when I get there – some sit around the nursing station documenting in charts, or socializing, waiting for the day nurses to arrive so they can give report, and others are still in and out of patient rooms. I go into the locker room, change into my bottom scrubs, put my hair up, and get myself ready for the day. The usual 4 pockets I have on my scrubs, which sometimes feels like 50 pockets, are already crammed with my report sheet, writing utensils, scissors, flushes, alcohol swabs, and empty labels, by the time I get report. I grab an available WOW (Workstation On Wheels – which used to be called Computer On Wheels/COW until patients thought nurses were referring to them as cows and complained) and declare it mine for the shift. I never bother to seek out one of the only four automatic vital signs machines on the unit that some nurses are known to hide away from others. I look at my patient assignment for the day and start copying key information from the Kardex (i.e. a quick reference for each of the patients’ needs).

7:05AM. I’m ready to start my day.