Thursday, July 22, 2010

My brain hurts

Such confusions and complications. I had a difficult night. Not difficult with clinical skills, difficult with figuring out who was in charge of my patients! First the Neurosurgery Trauma team orders a follow up head CT on my patient, then the ENT team adds Temporal Bones with the follow up CT, then the radiologists tells the techs Temporal Bones can be added to the initial head CT, so the techs cancel the second head CT not realizing the follow up order was written by a different team for a different reason! As I'm arguing with the techs, the patient is now two hours late for the exam. Of course the neurosurgeon calls my wondering where the follow up is, fortunately he was understanding and contacted the radiologist to clarify the confusion. Finally my poor patient got to go to the scanner, to find a worsening head bleed. So I had to travel again for another follow up. Then in the morning, ENT doctors order ear drops for my patient who is bleeding out her ear. Neurointensivists later comes to the bedside for their assessment and don't even look at what other teams have ordered. I tell them, by the way ENT wants this, they looked at the order and said, "WTH! How will we know what's leaking out? Cancel that order!!" In the midst of all this, Neurosurgery calls to order upright xrays to clear the patient's (who is sitting upright and has been for 4 hours) mediastinum since apparently it wasn't done before. I send the order to radiology, and the doctor calls back saying, "Nevermind, I found it."

In the meantime, I'm tracking down the ordering physician for my other patient who has to go for a head CT for temporal bones since the techs told me it was cancelled, but I had no order! I finally get ahold of the correct radiologist, since the one in the office at the time didn't want to "deal with it" and got my verbal order.

Remember I'm a traveler in float pool. I oriented on this unit once during a day shift and I work graveyards. Yes I have worked two night shifts, but it is still very difficult to figure out what the hell is going on amidst all the miscommunication. I am impressed with the staff nurses who hold it together so well, perhaps it's because they've dealt with this for so long.

OK, my venting is done. Now I have 7 days off for climbing and biking!!


Tuesday, July 6, 2010

SO MUCH TO LEARN

The beauty of nursing is the constant learning and teaching. It never gets old. Whether it's equipment or clinical, something can be gained everyday. My favorite, I think hilarious though the Resident probably won't, is when the Resident came to me full of excitement that he had found a 16Fr coude catheter,
but it wasn't, it was a 28Fr three way irrigation catheterFinally the correct catheter was found, and the Resident told me he has never placed a coude before, but needs to. Unfortunately the patient heard him say this, so he lost his chance. Darn! Fortunately a competent male nurse was available for the procedure.

There are many differences between working back home and working at a big Trauma I teaching hospital. I am following the advice of previous travelers,
"Take it all in, ask a lot of questions and stay on your toes!"

Saturday, July 3, 2010

Red, White and Dead!

RED, WHITE AND DEAD
Fremont randomness again. In an attempt to gain the Guiness Book of World Records title for "Most people dressed as zombies in one place," FREMONT WINS!!
My friend and I participated in the fun, there were a lot of clever costumes. Would you ever believe 4,233 people would collect in one location dressed as zombies? It could only happen in Fremont.
Apparently Fremont won the title last year with 3,894 participants, but then England's Big Chill Music Festival took the title with 4,026 zombies the same year. So of course, Fremont had to win it back. Perhaps next year Fremont will reach its intended goal of 5,000.

Saturday, June 19, 2010

Summer Solstice

Ahhhhh FREMONT!

This was the most interesting parade I have ever seen. A two hour long parade for summer solstice in hopes the sun would come out soon. Not only were there naked bikers, but other performers (fully clothed) with expertise in hula hooping, swing dancing, belly dancing, roller blading, musicality, theather and others.
The day started with sprinkling rain, pretty common, and stayed gray through the afternoon. Fortunately the rain let up before the naked bikers began their trek down the street; if it continued to rain, their pain would smudge, and that would be bad. The idea of this parade is to represent life and earth. There were no motorized vehicles in this parade; each float was powered by people. Very fascinating. The people next to us mentioned this was the biggest, longest and best turnout this event has ever had.
video

Friday, June 18, 2010

GOOD TIMES IN THE ER....AND NEURO ICU


All finished with hospital and clinical orientation, and now on my own. My ER orientation was great. I was fortunate to have an awesome preceptor for two days. There were some gnarly things I saw which I wanted to snap a photo to share, but figured not such a good idea when the resident got some weird looks after he did it. The ER there is BUSY! Waiting room times average 3 hours, then 4 hours in the unit if it is for something simple. People can wait for 3 hours more to get a bed if they get admitted. The first shift after orientation I was floated to Neuro ICU which I'm thinking will be the unit we get floated to the most. Nobody wants to be there, and it's the biggest unit in the hospital that also brings in the most revenue. Patients on the unit range from strokes to full spinal cord injuries with paralysis. There is new equipment to learn, and pathophysiology to brush up on. The nurses in the unit were helpful and friendly. Most of them were travelers in the past, or want to be a travel RN in the future.
Last weekend we enjoyed some hiking and scenic photography in Olympic National Park. It was the first time I've taken a ferry! We spent all afternoon and had lunch at a beautiful lake.
The rest of the week has and will be spent on visiting the Aquarium, Zoo, Science Center and the festivities of Fremont this Saturday to celebrate the Summer Solstice. Apparently the people get painted up and ride their bikes naked in a parade, it should be very entertaining.

Today we went on a hike and I really like where we live. There are beautiful trails everywhere. Last night was our first time driving to work, since we've been taking the bus for day shifts, and we were there in less than 10 minutes. It was great! Here's a picture of the neighbors and what the parks are like here. It is absolutely beautiful. Yes, that is the plane the owner probably takes to work. The other picture is of the trail through the park.








Thursday, June 10, 2010

Hospital Orientation DONE!

WOW! Who woulda thought three days of orientation could be so difficult to get through. The content was good overview, and the instructors were prepared, but I just wasn't into it. Fortunately the paperwork and passwords are done and tomorrow I get to start Trauma ICU orientation. Very EXCITING!

Between days of orientation, I have learned to ride a bus, understand a paper bus route schedule, made my way through a giant hospital, politely said "no" to pan handlers, found fresh flowers and delicious pears at Pikes, made friends in elevators, located the recycle bins, seen a really neat fountain, watched kids at the skate park, operated a PO box, been to the top of the Space Needle, learned to jam on the bass at EPM, became more cultured about WoodStock and Jimmy, ventured the SciFi Museum and watched INNER SPACE for the first time. Oooo Dennis Quad!

We have had beautiful weather, seen eclectic people and enjoyed awesome Thai food. By the end of this trip I will have a BuCkET LiST to share. In the meantime, feel free to come out and share it with me:)

Wednesday, June 2, 2010

Made it!

The plan of 13hrs to get to the new place ended up being over 24hrs! The first 4hrs of the drive went fantastically, I had a lot of energy. Then we stopped for food, then I went into a food coma and only managed to drive 2 more hours before begging to pull over for a quick 15min nap, which ended up being a 2hr nap, ha ha! That's what happens when I pack all day then try to drive all night. After the nappy nap, I managed another hour drive, then I was hungry again, then went into another food coma. I tried Guava Rockstars to keep me going, and I even attempted half a NoDoz. The NoDoz worked the first time, but not the second time and I wasn't about to take a whole pill while downing RockStars, talk about arrhythmias!
I have a great RN recruitor, housing coordinator and realator. These are all good things to have when you aren't on schedule. The rental furniture was already loaded, and we were definitely not going to be at the condo to let them in. Our housing coordinator managed to get the rental guys to show up as late as possible and our realator was able to let them in. It was so nice showing up to a condo fully furnished with beds and lamps already set up.
Speaking of lamps. The BF and I disagreed about whether to pack lamps or buy new ones. I won that argument and we didn't bring any. Apparently we should have brought some because the place is so dim, it's depressing. We bought a bunch of new DayLight CFLs and an extra standing lamp. It is so bright and happy in here now! And hearing the fountain outside the balcony just makes it better.
Our first trips since being here have been Ikea, Costco and Lowe's. And we spent an evening with a friend of mine who, as it turns out, lives less than 3 blocks away! Great places to start. The majority of things are put away, we are just waiting for a few FedEx boxes filled with fun outdoor activity items such as a tent, bbq and sleeping bags.
The GPS has been a lifesaver getting around these crazy spaghetti bowl freeways. Turns out work is less than 5 miles away, next thing on the to do list is to find the bike route to work. There is also over 110 acres of parks and hiking/biking trails on this little island. The perimeter is 14miles or so, perfect for marathon training!
To Do List for today (besides the bike route)
1)buy an alarm clock
2)find delicious Pho (already found delicious Thai)
3)explore a trail
4)find Pilates studio
5)find Dance studio
Good times! And work doesn't start until next week!