Nurse's Notes
Finally found the time and motivation to sit down and recap life as a nurse so far (the motivation probably comes from the fact that I'm supposed to be packing up my stuff right now since I move on Saturday...). Last Wednesday, was my first official day of work (with a preceptor). Here's what's been going down since then....
Wednesday, First day of work
Woke up super early for showering. Getting ready for breakfast, I looked in the mirror to make sure scrubs weren’t wrinkled, hair was in place, etc. I looked at myself in uniform and began to have panic attack. First thing that went thru my mind: “Who the F*** told you that you could be a nurse?” Spent next 10 minutes freaking out, convinced that my preceptor was going to be mean, I was in over my head, and that I knew nothing and was sure to kill somebody’s baby. Billy called to talk me off the ledge (‘cause he’s wonderfully good at that) and I headed in.
Preceptor is SUPER nice, her name is Monica, and she’s a UM ’05 grad. Walking into the unit I saw my name up on a certificate above the charge nurses’ desk congratulating me on passing my NCLEX. Nurses and doctors [whose names I don’t even know] were congratulating me all day on my new status. (Dr. Lenoir, one of our attending MDs actually was walking by me yesterday and just said “congratulations” to me, randomly…we’ve never spoken EVER). Got our assignment, walked in and I knew it was gonna be ok. The night-shift nurse was Tania (a girl I did orientation with back in January), and the other nurse in the room was Jeanine (a PICU float nurse I’ve been care assistant for a billion times). We had 3 patients, so Monica gave me one of them. Once I got report, all sense of fear and panic melted away, and it was like I’d always been there, doing this job. I got all my updated codes from the CNS and went to work assessing my baby and charting (got a little misty when I signed my first note in the computer and it came up as “Nicole Nazon, RN”). Its all stuff I learned to do during clinicals, only with added responsibility (and liability).
During the first day, Monica said all my charting was perfect-thanks to Gina, my preceptor last semester, who kicked my ass. I also was able to access the medpoint system to scan medications, and get the really good stuff out of the pyxis. My whole day was feeding and giving meds and receiving orders, etc. In my downtime, I used the online scheduling system to make sure I got days off for the UM vs. Texas A&M and GA Tech games. During lunch I ran to HR (which is in another building) to fill out my benefits form, managed to shove a cheeseburger down my throat while I talked to Billy for a few before heading back into the unit. The rest of the shift was fairly calm, and Monica gave me a tour of the unit (learning codes to open the doors, where we find different forms, etc). At the end of the shift, I was feeling really well until she asked me if I was ready to give report. The panic started to come back, but Tania was back for the night shift again so report was easy and comfortable. I headed home feeling uber accomplished and proud of me. Called Eme (it was here first 12-hour shift as well!) and my mom, went to publix, and finally called Billy so I could talk before he went to bed. Day 1 of nursing a complete success!
Days 2-5 have gone by in a busy kind of blur. NICU orientation is done in 2 parts, and your probationary period/evaluation is spread out over a year. Right now I’m orienting to Level II nursing, which are the more stable patients. I get 5 weeks of orientation with a preceptor (2 on day shift, then 3 on nights) after which I’m on my own for Level II assignments for the first 6 months of working. After 6 months, if we feel I’m ready, I get another 5 weeks of orientation to level III (these are kids on ventilators and multiple medication drips and are really REALLY sick). Well the NICU is the one unit in the hospital that is ridiculously short-staffed and on Day 2 they didn’t have enough Level III nurses working so they had to switch our assignment so my preceptor could take a level III assignment. Which means I had to take a level III assignment. Only 2 kids; one on a vent, and one I’ve worked with before who is constantly fussing and a terrible eater (trying to feed him is a ridiculous process). The charge nurse and CNS apologized for the disruption in my orientation schedule but it was ok; I was told if I could handle the poor feeder on my own, with all his special needs, I should be able to handle any level II assignment. So I did, and it was exhausting, but fabulous.
On Days 3 and 4, Monica gave me 2 of the 3 patients we were assigned, and yesterday we had 4 patients + a care assistant, and I asked her if I could take 3, just to see if I could handle it. Of course I could handle it; needed help from other nurses thanks to short staffing (had to take a patient down to radiology, which took FOREVER).
So in my first 5 days of working I’ve done a lot. I [inserted and] gave feedings thru OG, NG, and G Tubes, I’ve pushed Phenobarbital, Ativan, and Methadone. I called Pharmacy 4 times because one of the MDs was being lazy and wrote an order that didn’t make sense (We eventually clarified and I had to ask him for a new order so I could get the right meds). I called the lab to confirm how much blood they needed for a test. I attempted to start an IV (babies have TINY veins!!!), I did a blood gas and a glucose check, I’ve changed vent settings, I’ve faxed orders for consults, I’ve weaned a baby to a lower oxygen setting, I paged the MD on call with critical lab values, I answered questions during rounds, I’ve delegated tasks, I’ve taught parents, I’ve taken telephone orders, I’ve managed 3 patients on my own with a care assistant for feeding, and I discharged a patient home (which was an AWESOME day, cause that kid’s been here for over 3 months, his mom and I talk all the time when I come into work. We all cried a little when it was time for him to leave).
So that’s work. I love the team feeling in my unit, and how all the nurses in the rooms help each other out. I love that there are 6 TVs in room 5, and at one point yesterday they were ALL tuned into Dr. Phil because of the interesting story unfolding. I love that every day I see someone else that I’ve worked with in the past, who congratulates me on my new status. I love that I can make judgment calls on patient care and people agree with me and recognize me as their equal. I love joking around with the nurses about stupid Docs who right STUPID orders. I love scrubbing in every morning before I start my day (Required for our unit). I love getting paid to hold and sing to tiny babies. I love listening to my favorite traffic reporter on the radio during my morning drive. I’m busy all day and tired at night and so proud of myself its sick. I love my job.
Wednesday, First day of work
Woke up super early for showering. Getting ready for breakfast, I looked in the mirror to make sure scrubs weren’t wrinkled, hair was in place, etc. I looked at myself in uniform and began to have panic attack. First thing that went thru my mind: “Who the F*** told you that you could be a nurse?” Spent next 10 minutes freaking out, convinced that my preceptor was going to be mean, I was in over my head, and that I knew nothing and was sure to kill somebody’s baby. Billy called to talk me off the ledge (‘cause he’s wonderfully good at that) and I headed in.
Preceptor is SUPER nice, her name is Monica, and she’s a UM ’05 grad. Walking into the unit I saw my name up on a certificate above the charge nurses’ desk congratulating me on passing my NCLEX. Nurses and doctors [whose names I don’t even know] were congratulating me all day on my new status. (Dr. Lenoir, one of our attending MDs actually was walking by me yesterday and just said “congratulations” to me, randomly…we’ve never spoken EVER). Got our assignment, walked in and I knew it was gonna be ok. The night-shift nurse was Tania (a girl I did orientation with back in January), and the other nurse in the room was Jeanine (a PICU float nurse I’ve been care assistant for a billion times). We had 3 patients, so Monica gave me one of them. Once I got report, all sense of fear and panic melted away, and it was like I’d always been there, doing this job. I got all my updated codes from the CNS and went to work assessing my baby and charting (got a little misty when I signed my first note in the computer and it came up as “Nicole Nazon, RN”). Its all stuff I learned to do during clinicals, only with added responsibility (and liability).
During the first day, Monica said all my charting was perfect-thanks to Gina, my preceptor last semester, who kicked my ass. I also was able to access the medpoint system to scan medications, and get the really good stuff out of the pyxis. My whole day was feeding and giving meds and receiving orders, etc. In my downtime, I used the online scheduling system to make sure I got days off for the UM vs. Texas A&M and GA Tech games. During lunch I ran to HR (which is in another building) to fill out my benefits form, managed to shove a cheeseburger down my throat while I talked to Billy for a few before heading back into the unit. The rest of the shift was fairly calm, and Monica gave me a tour of the unit (learning codes to open the doors, where we find different forms, etc). At the end of the shift, I was feeling really well until she asked me if I was ready to give report. The panic started to come back, but Tania was back for the night shift again so report was easy and comfortable. I headed home feeling uber accomplished and proud of me. Called Eme (it was here first 12-hour shift as well!) and my mom, went to publix, and finally called Billy so I could talk before he went to bed. Day 1 of nursing a complete success!
Days 2-5 have gone by in a busy kind of blur. NICU orientation is done in 2 parts, and your probationary period/evaluation is spread out over a year. Right now I’m orienting to Level II nursing, which are the more stable patients. I get 5 weeks of orientation with a preceptor (2 on day shift, then 3 on nights) after which I’m on my own for Level II assignments for the first 6 months of working. After 6 months, if we feel I’m ready, I get another 5 weeks of orientation to level III (these are kids on ventilators and multiple medication drips and are really REALLY sick). Well the NICU is the one unit in the hospital that is ridiculously short-staffed and on Day 2 they didn’t have enough Level III nurses working so they had to switch our assignment so my preceptor could take a level III assignment. Which means I had to take a level III assignment. Only 2 kids; one on a vent, and one I’ve worked with before who is constantly fussing and a terrible eater (trying to feed him is a ridiculous process). The charge nurse and CNS apologized for the disruption in my orientation schedule but it was ok; I was told if I could handle the poor feeder on my own, with all his special needs, I should be able to handle any level II assignment. So I did, and it was exhausting, but fabulous.
On Days 3 and 4, Monica gave me 2 of the 3 patients we were assigned, and yesterday we had 4 patients + a care assistant, and I asked her if I could take 3, just to see if I could handle it. Of course I could handle it; needed help from other nurses thanks to short staffing (had to take a patient down to radiology, which took FOREVER).
So in my first 5 days of working I’ve done a lot. I [inserted and] gave feedings thru OG, NG, and G Tubes, I’ve pushed Phenobarbital, Ativan, and Methadone. I called Pharmacy 4 times because one of the MDs was being lazy and wrote an order that didn’t make sense (We eventually clarified and I had to ask him for a new order so I could get the right meds). I called the lab to confirm how much blood they needed for a test. I attempted to start an IV (babies have TINY veins!!!), I did a blood gas and a glucose check, I’ve changed vent settings, I’ve faxed orders for consults, I’ve weaned a baby to a lower oxygen setting, I paged the MD on call with critical lab values, I answered questions during rounds, I’ve delegated tasks, I’ve taught parents, I’ve taken telephone orders, I’ve managed 3 patients on my own with a care assistant for feeding, and I discharged a patient home (which was an AWESOME day, cause that kid’s been here for over 3 months, his mom and I talk all the time when I come into work. We all cried a little when it was time for him to leave).
So that’s work. I love the team feeling in my unit, and how all the nurses in the rooms help each other out. I love that there are 6 TVs in room 5, and at one point yesterday they were ALL tuned into Dr. Phil because of the interesting story unfolding. I love that every day I see someone else that I’ve worked with in the past, who congratulates me on my new status. I love that I can make judgment calls on patient care and people agree with me and recognize me as their equal. I love joking around with the nurses about stupid Docs who right STUPID orders. I love scrubbing in every morning before I start my day (Required for our unit). I love getting paid to hold and sing to tiny babies. I love listening to my favorite traffic reporter on the radio during my morning drive. I’m busy all day and tired at night and so proud of myself its sick. I love my job.