September 12, 2009

First week over

It's been a busy week.  I've been on a few different units so I'm getting to meet more of the patient population as well as staff.  So far, all the staff have been good to work with.  The patients are interesting:  there's a wide spectrum of personalities there from very high-functioning to...well, the not very high-functioning.  Many of them liked to talk to me, probably because I was new.  One patient tried some staff splitting, but fortunately I went to talk to the tech about his request first.  Another patient made me nervous when I was assessing him since he went from completely out of it to completely coherent in mid-sentence and jumped up (so I couldn't help but bounce back a bit).  But overall I'm going in with a good mixture of bravery and caution.  And I'm getting very good at ensuring that doors are always shut behind me.

Nothing beats on-the-job training.  They may have explained the job to me in orientation, but to see it in action really makes me understand how all of the pieces of it fit together.  I'm learning a lot about what to do...and what not to do.  Not that the "not to do"s are doing anything wrong--it's just I'm seeing particular methods of doing things that, while they work for others, don't sync with how I know I work.

Right now, 95% of my job involves passing meds.  New nurses start off with passing meds, then they start charting, then they progress up to charge nurse roles.  I really need to get cracking on refreshing my medication knowledge, especially side effects and how fast they take action, because in the last unit I was on there were a lot of medications given out that needed to take action fast.  I also need to learn brand-names because most of the orders use brand-names while I know the generic names.

I've also seen how manipulative some of the patients can be, especially when it comes to meds.  On the first day, some thought that, with me being new, they could pull one over on me and ask for extra doses "because that's what they always take/that's what the doctor changed it to/so they don't have to come back in an hour/whatever."  To which I smile and reply, "I'm sorry, but I can only administer medication as ordered in your record."  Repeat as needed.  After a couple of days, that stopped.

Next week I'm on the higher acuity units, so I've started thumbing through my psych textbooks just to refresh myself on the basics of the common psych conditions.

In the non-nursing world:  I see the endocrinologist next month.  Until then I've been doing the DVD, working out on that treadmill and watching what I eat, and it's still a losing battle.  I won't step on the scale--I'm going by the fit of the clothing.

Right now, I need a nap.  Horror movies + Dr. G, Medical Examiner = strange dreams and a none-too-restful night's sleep.

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