March 29, 2010


It is an utterly bleak and rainy day...which is doing nothing for me getting my statistics coursework done. Right now I'd rather be sleeping. I don't know what it is, I'm just so tired lately. I know it's not my thyroid, and I'm getting plenty of sleep on my days off. Hmm...

I finally got to WW to weigh in. +0.2 lb...which is not bad if you consider that my last weigh in was on 3/1. I've managed to keep my weight stable. But I need to get cracking on getting it back down.

March 27, 2010


One of the advantages of being a student (albeit a class-at-a-time one) is that I qualify for educational discounts on software.  Yesterday, I picked up Microsoft Ultimate Office 2007 for about $60, and since I bought it so late in the game--only 3 years after the fact--I qualify for free upgrades to Office 2010 when it comes out.

I've managed to avoid Word and Excel 2007 for most of the last 3 years:  the only times I ever ran across it was in the computer lab at school.  At home, I have (had) the 2003 versions, and I use Works on the Mac.  I usually save files in RTF format because I never know which computer I'll be on.  But now that I'm on 2007's almost like learning a whole new language.  Nothing is where I remember it being.  The one thing that's saving me right now is that they haven't changed the short-cut keys.

Statistics blows right now.  I'm learning it but I don't feel like I understand it.  Instead, I feel like I get enough of it to do well on the quizzes, then the information goes straight out of the brain as I tackle the following week's chapter.  I have 5 separate assignments and a quiz due by Monday...and lest you think I'm procrastinating, my instructor dumped 3 of them on the class on Thursday (the weekly homework and quiz are a given).

I'm having a hard time concentrating on the reading right now.  It's late, I'm tired (despite the two-hour nap I took today), and I'd rather be doing other things on a Saturday sleeping.  Or reading.  Knitting sounds good too.  I'd also say watching Dr. Who, but it's pledge drive week on PBS so it won't be on.   But I've got to work tomorrow, so I need to slog through some of this tonight.  Whee.

March 26, 2010

Not so good

I'm not talking about myself.   FYI:  no word yet on the application...but that's all right.  I've heard more about the downside of going permanent since I put it in, so I'm not in any rush.  I'm also taking all I hear with a grain of salt as I need to judge things for myself, so I'm still going to see what they offer me. 

What was not so good was that we had to escort some student nurses off of the unit because of their behavior.  They were both entitled and treated the staff rudely and obnoxiously...which while not great, is something that could have been overlooked, especially if that was their only crime.  Taking charts without telling us is also forgiveable, again if that was the extent of their transgressions.  What was inexcusable was that these students were disruptive to the groups and milieu.  They bitched about having to do vitals.  They bitched that we didn't have machines but manual equipment.  They were so focused on getting their assignment done that they went into a group, sat down and started talking to their selected patients while the group was still going on.  Then they bitched to us when we pulled them out of the group and explained to them why they can't do that.  Then they went back in and DID IT AGAIN.

We told their instructor to take them off the unit and they were not allowed back.  If I'm charge tonight on my unit, they won't even be allowed to set foot on the floor.

Lest you think I'm an uppity "she's just a new grad, why is she pulling this attitude" monster...I wasn't a student too long ago, and I remember the pressure of having to get info to complete care plans and assignments and flow sheets.  I remember the struggle of trying to balance patient care and research.  I remember feeling like some days feeling like I never had enough time to get to a chart and other days it feeling like all I did was have my nose in a chart.  I rememver feeling frustrated that I couldn't do things when/how it seemed so convenient for me to do them.  And I certainly remember what CIs were like.  So I do have a shadow of sympathy.

At the same time, I was also taught that the patients are not there for our convenience:  they are in the hospital to get better.  The patients can't just be pulled out like you pull a chart off of the shelf, used and then tossed back.  It's demeaning to the patient to be treated not as a human being but as an object of study.  And even worse, to do this in a group is to not only impede that patient's recovery but all of the patients'.  

And I was taught that as a student, I'm not entitled to be in the hospital.  Even though I was on my clinical, I was their guest, and as such I should conduct myself as a guest should.  I should not disrupt  the floor's routine.  I should follow the rules of the unit to a T.  I should speak to the staff there with courtesy (I didn't have to be obsequious, but I damn well had better been polite).  And if corrected I shouldn't take on an attitude and/or bitch back, but listen to what I'm told.   Maybe the staff is wrong and I was right--no one is perfect, after all--and then I could speak up politely.  But a majority of the time, we all damn well know I (as the student) was in the wrong.

I told their instructor that when I was in school, if I had acted like their students did today, not only would I have been removed from the clinical site immediately, I would probably have been failed for clinical...and depending on the instructor I had, I may have even been flayed alive JUST for having the attitude.

It feels weird saying these things, when I'm only 7 months out of school myself...but working on the floor those seven months has taught me a lot.  Especially that my CIs knew exactly what they were talking about when they taught me.

March 23, 2010

They asked

Today, the DON asked me if I wanted to go permanent. I told her...I'd think about it. So much for likely turning it down.

But I did think it over...and after talking the pros and cons over with most of the unit, as well as with one of my favorite supervisors, I've put in my application. I figure I'll see what terms we can come to and go from there. Worst case scenario: I don't like what they offer, I say No and I'm still PRN staff.

I never made it to Weight Watchers the other day...but I stepped on the scale and got 186. It's day 2 of being back in the far so good. I passed up cake during lunch and settled for an orange for dessert. Mind you, had I passed up lunch itself for a salad I'd have really scored points. But I at least made it up by having that salad with some soup for dinner.

March 21, 2010


They pretty much went along with whatever I checked on the evaluation, rating me a bit higher than I did in a couple of areas (none were lower, thank God).   The feedback was good, so I guess I have a job for another six months. 

 They've hired on several PRN people as permanent staff...they haven't approached me yet, probably since with my current schedule I wouldn't neatly fit into a one-shift position.  Which is just as well as I'd likely turn the offer down:  I like the flexibility and freedom that being PRN offers me.  I'm certainly not lacking for hours:  I do 32 a week now and could easily do 40 (or more) if I wanted, or scale back to 8 and still keep my job.  And I set my own hours--I don't have to work around anyone else's schedule (although coincidentally, what I can work happens to mesh rather well with what days the permanent staff can't work), and can take off on four hour's notice if I had to.  I'd still like to be asked to join know, to get a little stamp of "hey, you're really doing OK, want to sign on?"  And I'd like to think it's my schedule that prevents them from asking, and not my performance. 

Insecure much?  I vacillate, as you can see.

Work has been rough lately due to staffing issues.  There are just not enough techs on our floor.  There's also not enough nurses either, but it's manageable with one nurse as long as there are enough techs.  The problem (I think) is that TPTB don't realize that while we on detox don't have the actively psychotic patients who are throwing things, or the depressives who will try to kill themselves the moment our backs are turned, we have the most medically unstable patients, particularly the new admits who are fresh off of the drugs.   They require frequent reassessment.  Neverminding that as far as therapeutic groups go, we have the most of any other unit with the exception of the kids. 

One evening was so bad that all staff who were there including myself made formal complaints.   We're not miracle workers:  it's hard to do the job without the tools and the necessary staff.  So we shall see if the mass complaints improved things.

Seven months...I hit seven months in a few days, and the end of the magic year is in sight.  As I told my better half this morning, it's not as though I'm going to leave my current job the minute the clock strikes 12, but that having that magic year's experience under my belt is so mentally liberating.  I do have the freedom to leave and be actively competitive for other jobs--I'm no longer limited to applying for "new graduate" positions.   Hospitals will want to talk to me once the new grad slime has worn off.

One of the supervisors--not as part of my evaluation, mind you--strongly recommended I do get med-surg experience. Truth be told, the further along I go in psych, the less I want to go into med-surg. I enjoy psych a lot more: the work environment, what I do, the decreased amount of blood, guts and body fluids, and the fact that 30% of my job isn’t made up of “pillow-fluffing” type duties.   There's definitely psych jobs out there so it's not as though I'm in an impossible-to-find specialty.  Also, given my age (not old, not young), it's not as though I'll be in nursing for the next 50 years.  I'm thinking only 30 or so before I hang it up and retire, so why not enjoy a specialty right out of the gate?

But I could see her wisdom...that year's experience would give me more options.  I do like options:  even if I never use them, I like knowing they are there if I do want them.  So I figure I'll get my year's med-surg after I finish my BSN.   I'll be a new grad twice over.  Until then, for the next couple of years while I'm in school, psych it is.

Speaking of which, that's going well.  Another class starts at the end of the month, so for April and most of May I'll be doing two classes at the same time.   Fun.

I need to get back on the Weight Watchers wagon tomorrow…the fast and loose living has caught up with me, and tomorrow I need to see how bad the damage is.  Some pants aren't fitting properly, and I just feel heavier lately.  But I've no one to blame but myself.  I’ll never lose weight if I don’t be disciplined about it…problem is that it’s hard to maintain that discipline after a few weeks.  I’ve got to find a new approach to this problem…I’ve lost weight before, I know I can do it again.

I also joined up with a local parenting group.  Besides giving my little one an opportunity to do more things, I need to get out more and play with people my own age...particulary ones with little ones of their own and who can relate to me right now.

March 6, 2010

This fecking self-assessment

I admit that I'm a damn good nurse.  I'm told it by many I work with, from techs to other nurses to doctors.   But I also hold myself to a high standard...somtimes, too high of a standard.  And that, I've also been told by many I work with, from techs to other nurses to doctors.  It is probably because of those high standards I hold myself to that while I admit I'm a damn good nurse, I'm also insecure about my performance.  It's hard to explain, but that's how I feel.

I hate self-assessments in that I honestly can't give myself the highest marks.  I'm still learning the ways of the psych world, I've made mistakes (though have owned up to every one), and given that I spend most of my time in a certain area (detox), my experience and skills are stronger in that area; areas I spend less time in, my experience is less strong due to lack of experience.  I'm good, but I'm not perfect.  So I filled out my self-assessment accordingly.

Other people tell me to just score myself highest marks for everything.  I tell them I can't as it would not be true.  One person said they did this for themselves, neverminding that they've committed several serious medication mistakes and was once written up by a patient for their behavior I didn't have anything to say to that...couldn't think of anything to say to that, actually.  In all fairness, it's not my place to judge whether their assessment is truly accurate as I'm not them nor their superiors...though I did admire their cojones for a fleeting moment.

So we'll see what happens.  I'm wondering if my self-assessment even matters at all, that they're just going to rate me however they want and what I think has no say in the matter. 

Now that I'm in the downhill side of the first year hill...I feel more seasoned.  I'm now precepting new staff, which is cool.   I'm putting my foot down on things when I feel they're inappropriate or if I feel that I'm being taken advantage of because I'm a new grad.  I'm not letting the fact that I'm a new grad stop me from giving input on programs and voicing my opinions.  And I now give great PPDs--it helps when you have to do 6 in two days.

There's always new things to learn and I'm always open to the lesson.  I learned a lot about the best medication administration times from the LPN I worked with last night.  Did you know Wellbutrin can keep you up at night?  I didn't...I do now, so I know to suggest to the doctor they may want to move the evening dose up earlier.  Or the lesson from the tech about the safest way to arouse a patient who's difficult to arouse:  gently rub their shoulder, then jump immediately back out of arm's reach?  I hadn't thought of that.  I can bring on the Voice of God whenever I have to (I had a lot of practice on the preschooler), but doing that plus banging the wall did nothing to get this patient awake.  But damned if I didn't brush his shoulder and he sprung up wide awake.

March 2, 2010

Halfway there...

I'm officially past my six-month mark as an employed RN.  I've been licensed for 8 months, but the first two were spent both job hunting and volunteering.

You know what this means, right?  Yup...evaluation time.  Tonight will be spent puzzling out my self-assessment form so I can turn it in and get my proper evaluation.  The person who hired me is no longer there though, so it'll be interesting to see who they assign my evaluation to.