Tuesday, February 23, 2010

walking away from $27 in this economy

My first week as an RN involved:

- an LPN and a stockroom guy remarking that I looked "about 12 years old."
- taking my first telephone order from a physician. This task is pretty much mundane to experienced registered nurses, but to me it was my first, so it was automatically special. To those who are unaware of our roles, nurses have to notify the physician/nurse practitioner/physician assistant any significant changes that we observe in the patient. This is why nursing school takes 2 to 4 years: it's not just teaching us how to give bed baths, contrary to what TV shows and movies depict. Nurses are taught what those "significant changes" are, and the symptoms that lead up to them. We are their "eyes and ears" since we are the ones who are with the patients throughout the day. Physicians and mid-level providers mostly stop by to see their patients (which we call rounds) for only a few minutes to a couple of hours at best depending on the facility. In critical care units in the hospital, most of them are physically there 24 hours a day. In a sub-acute facility like mine, the physicians and mid-level providers only stop by twice a week! Not because they are too lazy, but only because the patients are not as critical like the ones in the hospitals. So, it is up to us, the nurses, to let them know through phone calls and pages for any changes so they can prescribe new medications or order a referral from a specialist. Now you know!
- eating alone in my car for lunch because I couldn't muster enough courage to eat in the break room with the other nurses for the first three days.
- the nurses in the station all singing "Fools Rush In" along a Fake Elvis they brought in for a Valentine's Day social for the residents. That moment I never would've expected to happen in the real world (maybe in Glee), but it did and gave me warm fuzzy feelings.
- being given the half of the hall by a nurse because it was "the easier side." I might be a new grad, but I know that giving me the only trach/G-tube patient in the unit and the new admit who just had vascular surgery is certainly not the easier side!
- one of the elderly residents (most likely with dementia) slapping my behind while I was preparing medication for my patients and feeling nonplussed about it... because she's done it most days I was there and to all the nurses as well! I didn't file a sexual harassment case, it just didn't seem right :P
- feeling like I truly "made a difference" when I helped my patient find her handheld radio. This elderly lady was blind, clutching a rosary to her chest and praying to herself for most of the day. I don't blame her at all--I would be doing the same thing and hanging on to any religious item I could get my hands on if all I saw was darkness all the time. Well, I remembered this patient holding a handheld radio the day before, but that day I saw her she was empty handed. I asked her where it was and she replied that no one could find it. I looked around her bed and inside her closet, where I found it. It made me wonder if people really did help her, when it was so easy for me to find. She thanked me graciously with a huge smile on her face, remarking that she could finally listen to her Christian radio again.

So I only lasted at SubAcuteFacility for 8 days. Whether I told them I couldn't come anymore was an impulse or not, I knew that place was not where I wanted to start my nursing career. I would get 15 patients and 30 when the part-time nurses don't show up. All I know is that the nurses who work in that floor (RNs and LPNs) are Superwomen who could handle the patient load. For me, it would mean rushing the assessment part (which is the most important part), or being scared most of the day that I would "forget" about someone, or something. I accepted this job as an act of desperation because it's been 5 months and I still couldn't land a hospital job. It would be selfish of me to take on more than I could handle only because I want a paycheck and another bullet to my resume. I know that I want my first job to have less patients. One where I can have more time doing assessments (which is the part of the day where I examine my patients for any "significant changes" I talked about earlier). Before my preceptor left, on one of the busier days, I joked that I would "quit today." She replied, "No, you're not a quitter..." Well I guess I am, but I never said I was Super RN, right?

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